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813 -780 -0020 City of.Zephyrhills Fire Fax - 813- 780 -0021 <br /> Permit Application <br /> ��ry� Permit Date Received _l,//l� Phone Contact for Per <br /> �.� v .,. . <br /> Owner's Name Illtin�U/ iLa• • L. Owner's Phone Number 1 (19 I ? 12'S9-- <br /> Owner's Address <br /> Fee Simple Titleholder Name I Titleholder Phone Number <br /> Fee SimpleTitleholder Address I <br /> Job Address 7-63F W/ Nil, Lot # <br /> Sub Division Parcel # <br /> mac.. <br /> n Bio-HazardWasteStorage - ANNUAL n Fumigation "Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum = Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation — midi 0 4� <br /> n mergency Generator> 30 kw n LP /Natural Gas - ANNUAL S <br /> Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL <br /> FM/ 'Semi' (j Other <br /> Sprinkler IT1 ❑ ❑ ❑ n Recreational Bum / <br /> - 1 1 J <br /> Fire Alarm n ❑ ❑ ❑ I I n Sparklers / <br /> :___ <br /> Hood Cleaning 0 ❑ ❑ ❑ I I n Sprinkler System Installati s <br /> Hood Suppression Er ❑ E ❑ I 1 n Standpipes (Sprinkler Sys <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> ED Fire Works <br /> E Flammable Application- ANNUAL 1 1 Valuation of Project <br /> n Fuel Tanks <br /> El Other. I , ,. , , „,,., .„.......",,,,,,,,„.,,,„,,„„...„ _.. M .. <br /> max,... ir. r r∎ <br /> Contractor Company A. ' , , ' '6 G <br /> Signature A � ,L Registered Wit' 1 Fe4 Current I Y / N <br /> Address I / / I License # I <br /> ELECTRICIAN Company <br /> Signature I Registered Y / N I Fee Current I Y/ N I <br /> Address I I License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N I <br /> Address I I . License # ( I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N 1 <br /> Address 1 I License # I I <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N - <br /> Address License # <br /> Directions: <br /> Fill out application completely. • <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (httpJ /appraiser.pascogov.com) <br />