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812-780 -(020 City of.Zephyrhills Fire Fax-813-780-0021 <br /> 'Permit Application <br /> Date Received — — / Phone Contact for Permit <br /> / 11 ``-- ,J,' 7( .ZG� <br /> Owners Name // � /,//Y /i'C�/ --1--- el Owner's Phone Number <br /> Owner's Address cP 176 ,< // A A/ C <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Address I <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> n 4 Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> El Controlled Bum I Hood Installation <br /> Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> I — I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> 'Qthy( ISemi (J 1Other l <br /> Sprinkler % ❑ ❑ I Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning CI ❑ ❑ ❑ I 1 n . Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ I 1 n Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation ED Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> n Flammable Application-. ANNUAL ) Valuation of Project <br /> I I Fuel Tanks <br /> Q Other. 1 <br /> ■teseiithaiii �rrn <br /> Contractor Company _ 111E111111111.Wi j�� <br /> Signature /P` lift Registered WM Fee Current Y / N <br /> Ad• =ss I License# I I <br /> ELECTRICIAN Company <br /> Signature I Registered Y / N i Fee Current I Y / N I <br /> Address I I License #. I I <br /> PLUMBER Company <br /> Signature Registered Y / N 3 Fee Current I Y / N 3 <br /> Address I I - License # I I <br /> MECHANICAL • Company <br /> Signature • Registered Y/ N 3 Fee Current I Y / N <br /> Address I I License # I I <br /> OTHER Company <br /> Signature Registered Y/ N 3 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 (http: /lappraiser.pascogov.com) <br />