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L413- 780 -0020 City of Zephyrhills Fire Fax - 813 - 780 -0021 <br /> Permit Application <br /> Date Received I 1.2-7-20/0 J Phone Contact for Permit I 6 1 3 11 1 1 ' 5 f <br /> Owner's Name I � ( f' bye I Owner's Phone Number I 1 I I ( <br /> •1 <br /> Owner's Address I <br /> Fee Simple Titleholder Name I Titleholder Phone Number I 1 1 I <br /> Fee Simple Titleholder Address I <br /> Job Address 7 /'l L c G( 310 C Lot # I <br /> Sub Division I Parcel # I I <br /> 11 Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly - ANNUAL <br /> ry [Semr'1:L11L!EM ty <br /> Sprinkler El CI ❑ n Recreational Bum Fire Alarm I ❑ ID ❑ I I E Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ 1 1 I Sprinkler System Insta tions <br /> Hood Suppression U ❑ X ❑ I I n Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL ( I Valuation of Project <br /> Fuel Tanks <br /> Other: I <br /> Contractor �� Company .4-/ C /)'1Y <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> Address J L/7(51 D ar pee, r- 131,1 7e- - — 'i/.!o 1 License # I if--R 301 G X .) 43-00 ' I <br /> ELECTRICIAN Company I <br /> Signature I Registered Y/ N I Fee Current I Y/ N 1 <br /> Address I 1 License # ( I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # ( I <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N <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 />