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813 - 780 -0020 City of Zephyrhills Fire Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received I /1 -10 -/o 1 Phone Contact for Permit ( C/3 I 1 980 1 1 /031 I <br /> Owners Name I 1l L\ 7,;e40, I Owners Phone Number I 1 1 1 1 I <br /> Owners Address <br /> Fee Simple Titleholder Name I Titleholder Phone Number I I <br /> Fee Simple Titleholder Address I I <br /> n <br /> Job Address I 7 7o' (Q CL it .G3 f U LOt # <br /> Sub Division I I Parcel # I <br /> n Bio- Hazard Waste Storage - ANNUAL Fumigation Tent <br /> El Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> 0 Controlled Bum n Hood Installation <br /> LJ Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> El Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly - ANNUAL <br /> 1Qtrlyi (Semi) (Aiil1 Other <br /> Sprinkler rj ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm E ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I %:,SKI Li Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I I Valuation of Project <br /> 0 Fuel Tanks <br /> n Other: I I <br /> Contractor Company 1T 'Q f € _ c I <br /> Signature �� Registered Y / N Fee Current I / N <br /> Address I ,SP / /Oayde // ..y/ 1 License # I <br /> ELECTRICIAN / Company I <br /> Signature Registered Y / N I Fee Current I Y/ N 1 <br /> Address I 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 <br /> Address I I License # ( I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <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 />