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813x80 -0020 City of.Zephyrhills Fire Fax -813- 780-0021 <br /> Permit Application <br /> Date Received i - 5- J 0 Phone � Co <br /> nta ct for Permit 7 1 7 6 3y (± O .S <br /> Owner's Name J /'.JC #< 0 Th-Z-- Owner's Phone Number <br /> Owner's Address /1 /,L OP 2 C , / / j G( <br /> / <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Address I <br /> ' <br /> -7,5 3q G A 11 61 V 0 <br /> Lot # <br /> Job Address <br /> Sub Division Parcel # <br /> Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct • n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL = Places of Assembly- ANNUAL <br /> i Carly ( lSemi1 7 Other <br /> Sprinkler ❑ ❑ n Recreational Bum <br /> Fire Alarm E ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning ❑ ❑ ❑ 1 1 n . Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ ( 1 E Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps = Waste Tire Storage ANNUAL <br /> Fire Works <br /> E Flammable Application- ANNUAL I Valuation of Project <br /> I - 1 Fuel Tanks <br /> Other. 1 <br /> Contractor Company <br /> Signature - -- Registered Y/ N J Fee Current I Y/ N 1 <br /> Address /y0 ,hE LC9 -17Zt if / 9, 4 _,,,,- c:,--,— x�( ) 3J4 ) ( License# I <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N I Fee Current I Y/ N 1 <br /> Address I License #. ( <br /> PLUMBER Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I . <br /> Address I . License # <br /> MECHANICAL • Company <br /> Signature Registered Y / N ( Fee Current I Y / N I <br /> Address I 1 License # 1 <br /> OTHER Company <br /> Signature Registered Y/ N 1 Fee Current I Y / N <br /> Address I License limimummiammum a.' <br /> Directions: . <br /> • <br /> FII 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 (http: / /appraiser.pascogov.com) <br />