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813- 780 -0020 City of Zephyrhills Fire Fax - 813- 780 -0021 Permit Application Date Received I I Phone Contact for Permit 1 11 1 1 Owner's Name I ej' / Z e l — / ZZQ 1 Owner's Phone Number IFf„3 p r' I I ?78 1 I,�a,: Owner's Address 1 7� , o7s a... z. �L Vb ZVAyr f/ ,• Fee Simple Titleholder Name I / I Titleholder Phone Number I I Fee Simple Titleholder Address I Job Address I I Lot # Sub Division Parcel # I I El Bio-Hazard Waste Storage - ANNUAL = Fumigation Tent I-1 Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL I Controlled Bum IT Hood Installation Emergency Generator < 30 kw I-1 LP /Natural Gas - Installation Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL ❑ ry 'Semi' f;� (nher Sprinkler ❑ ❑ ❑ 7 Recreational Bum Fire Alarm 0 ❑ ❑ ❑ I I 7 Sparklers Hood Cleaning 0 ❑ ❑ ❑ I I n Sprinkler System Installations Hood Suppression ❑ yr ❑ I 1 n Standpipes (Sprinkler Sys) n Fire Alarm Installation F1 Torch Roofing/Tar Kettle R Fire Pumps n Waste Tire Storage ANNUAL Fire Works LI Flammable Application- ANNUAL I I Valuation of Project El Fuel Tanks I Other. I I Contractor Company Signature Registered Y/ N j Fee Current 1 Y/ N j Address I I License # I I ELECTRICIAN Company Signature I Registered Y / N I Fee Current I Y/ N I Address I I License # I PLUMBER Company Signature Registered Y/ N I Fee Current 1 Y/ N I Address I I License # I I MECHANICAL Company I Signature Registered Y/ N I Fee Current I Y / N Address I I License # I OTHER /�,.� ` Company .T1q•, A.V6 EG?w?.. ' � \ � »YY� Q y1 I Signature Registered �� N � Fee Current I (5,/ N Address ) I I License # I ? � s py /g��, Directions: . . Fill 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 (httpi /appraiser.pascogov.com)