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813-780 -0020. City of Zephyrhills Fire Fax- 813- 780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit l <br /> Owner's Name 1 K i ttx 1 # 3% 1 I Owner's Phone Number I 1 1 <br /> Owner's Address <br /> Fee Simple Titleholder Name I Titleholder Phone Number I <br /> Fee Simple Titleholder Address I <br /> .4 <br /> i <br /> 1� ads 6 v ( Pc. 33Sw Lot# <br /> Job Address � K�1� � Q �������`� 1 <br /> Sub Division I Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL [1 Fumigation Tent <br /> n m <br /> Comm Exhaust Kitchen Hood /Duct (] Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Burn In Hood Installation <br /> F - 7 Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw In LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL nI Places of Assembly- ANNUAL <br /> IQtriy l (Semi I 'Anil Other <br /> Sprinkler ❑ ❑ ❑ n Recreational Burn <br /> Fire Alarm n ❑ ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning n ❑ - ❑ I I n Sprinkler System Installations <br /> / <br /> Hood Suppression ❑ �" ❑ I 1 n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation In Torch Roofing/Tar Kettle <br /> E Fire Pumps In Waste Tire Storage ANNUAL <br /> n Fire Works <br /> n Flammable Application - ANNUAL I I Valuation of Project <br /> 0 Fuel Tanks <br /> El Other: I I <br /> Contractor ,4J /,suit F, r r e 4 cA Company I <br /> Signature f- Registered Y / N 1 Fee Current I Y/ N I <br /> Address 500 PAS, 64 1/61 e Jew t ce k'�- a-gS I License # ( I <br /> , <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address I License # I <br /> PLUMBER Company I <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address I I License # ( I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current I Y / N 1 <br /> Address I I License # ( I <br /> OTHER Company I <br /> Signature Registered Y / N I Fee Current I Y/ N 1 <br /> Address I I License # I <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 (http: / /appraiser.pascogov.com) <br />