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81: '80 -0020 City of.Zephyrhills Fire Fax - 813780-0021 'Permit Application Date Received Phone Contact for Permit Owners Name i " � � rp-SCiq 7 Owner's Phone Number 1 l Owners Address S \vd • Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Address 1 Job Address CS � � � \r\ y () - Lot # Sub Division Parcel # Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent n Comm Exhaust Kitchen Hood/Duct • n Hazardous Material (Tier I1 or RQ Facility) ANNUAL Controlled Bum n Hood Installation n Emergency Generator < 30 kw n LP /Natural Gas - Installation Emergency Generator> 30 kw LP /Natural Gas - ANNUAL Sale Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL Lam isirnn Eja Other Sprinkler ❑ ❑ ❑ n Recreational Bum Fire Alarm El ❑ ❑ ❑ I I I I Sparklers Hood Cleaning ,� ❑ ❑ I n Sprinkler System Installations Hood Suppression = ❑ ❑ ❑ ( I Standpipes (Sprinkler Sys) n Fire Alarm Installation n Torch Roofing/Tar Kettle Fire Pumps Waste Tire Storage ANNUAL n Fire Works n Flammable Application- ANNUAL I I Valuation of Project Fuel Tanks Other. 1 Contractor L Company Signature Cc s S U c 0 -ct\ mho Registered Y / N 1 Fee Current 1 Y / N - Address $ Q C - ;,3 ; r U - ro -A J - - License # ELECTRICIAN Company Signature 1 Registered Y/ N 1 Fee Current I Y/ N Address 1 License #. PLUMBER Company Signature Registered Y/ N I Fee Current 1 Y/ N Address I ' License # MECHANICAL . Company Signature • Registered Y / N j Fee Current I Y / N Address I License # 1 OTHER Company Signature Registered Y / N _1 Fee Current I Y / N Address License # Directions: •.w FiII out application completely. • Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) • Supply two (2) sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http / /appraiser.pascogov.com)