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813:780 -0020 City of.Zephyrhills Fire Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received 1 0 Phone Contact for Permit Ma <br /> ,,.., .,.w... ... ((yy �,� ..... ....:..... .. ,}nom �-�7 ...: <br /> Owner's Name I OA- l:, k � 1 I Owner's Phone Number 1 t3 I -- 7,3 - 6. Q <br /> Owner's Address cU J &'f rt ( I ` (JD <br /> Fee Simple Titleholder Name I Trtleholder Phone Number <br /> Fee SimpleTitleholder Address <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> ED Bio-Hazard Waste Storage - ANNUAL ED Fumigation Tent <br /> El Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier H or RQ Facility) ANNUAL <br /> El Controlled Burn = Hood Installation <br /> El Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw ri LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL = Places of Assembly- ANNUAL I L <br /> W y ® Other I <br /> Sprinkler ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning El ❑ ❑ ❑ I 1 = Sprinkler System Installations <br /> Hood Suppression ❑ F2' ❑ I 1 n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps = Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I I Valuation of Project <br /> Fuel Tanks <br /> Q Other. I <br /> Contractor Company � L i (12-e <br /> Signature 1 o r. Registered [ejlEl Fee Curre Y / N <br /> Address 1 ( License # J ( <br /> ELECTRICIAN Company <br /> Signature I Registered Y / N I Fee Current I Y / N I <br /> Address 1 ( License #. I <br /> PLUMBER Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I ' License # <br /> MECHANICAL Company <br /> Signature Registered Y / N J Fee Current I Y / N <br /> Address I 1 License # I I <br /> OTHER Company <br /> Signature Registered Y/ N 1 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 />