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813-780 -0020 City of Zephyrhills Fire Fax - 813- 780 -0021 <br /> Permit Application <br /> Date Received 1 12- t 5 0 Phon e Contact for Perm g-)" <br /> Owner's Name 6 ///•e.4'J Ces f i / Owner's Phone Number I 0 l3 753 81 69 <br /> Owner's Address 6 s $ , { / L / v / <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address 61`C &- c ( / allid z A 33 5 2- Lot # <br /> Sub Division Parcel # <br /> ...xN_........e »Mi'+. x fix. r „ : :�r.r.�;,.a <3.:;f`�.n,'�` ANIMIATMVAAM7 - r"s'.gniv=: .sa.:It° k7 MAN&::aA' a <br /> n Bio-Hazard Waste Storage - ANNUAL El Fumigation Tent <br /> Ii Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I Controlled Bum El Hood Installation <br /> I — I Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> I1 Emergency Generator> 30 kw El LP /Natural Gas - ANNUAL Sal <br /> IZ Fire Protection Maintenance - ANNUAL FT Places of Assembly -AN • AL <br /> IOtriy) pert F I Other 4 /IV <br /> Sprinkler TI ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I I I Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I I 1 Sprinkler System Installs • <br /> Hood Suppression rrI ❑ ❑ 1 1 n Standpipes (Sprinkler Sys) <br /> I <br /> 14 (0 1 ' <br /> i Fire Alarm Installation -- --�� n Torch Roofing/Tar Kettle I <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> r7 Fire Works <br /> I Flammable Application- ANNUAL I .JaJ— I Valuation of Project <br /> pi Fuel Tanks <br /> I-1 Other. I <br /> t, , ,. tt , a:.:;,,... itik a.g_; : k MZEIRSMIb'IN: E :' .- N M a” MU:.,EZabg. EMIII'EV° N m WOR " ate" :d IEWI.; M K . .x, ,. # x <br /> Contractor ` Company /tom- "� 1 �� I <br /> Signatures ��� n�� � _ 7 ;4 . -v Registered Y / N I Fee Current I Y / N <br /> Address I A Q, , 7X X ff$ Ls Ad O 4„,,S , ?5/ 639) License# <br /> ELECTRICIAN Company <br /> Signature 1 Registered Y/ N I Fee Current I Y/ N j <br /> Address I / I License # <br /> PLUMBER Company <br /> Signature Registered Y/ N ] Fee Current I Y/ N I <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address ( I License # I I <br /> OTHER Company <br /> Signature Registered Y / N . 1 Fee Current I Y / N I <br /> Address j License # <br /> �D : ,.,...ts:, rm>..; a ......:.....: :_:eau:,saa «��wt.w�c.,.:s _.a.ea „n: «,a:H ixa: w: .aa�sezr.:�..�..,.a..,,:- u,a�B E,.:U.:«.,... a�;.., . :....e,M,,..c. ::...'a <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 />