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813- 780 -0020 City of Zephyrhills Fire Fax - 813 - 780 -0021 <br /> Permit Application <br /> Date Received , I Phone Contact for Permit 1 11 11 I <br /> Owner's Name I 1,e5 1 Owner's Phone Number (gP 1 199 7 1 1 G4 - a-2 <br /> Owners Address 1 �lj 4/02 "r „4/ �_ _ p !/ �2 / I <br /> Fee Simple Titleholder Name I �' I Titleholder Phone Number I I I I I <br /> Fee Simple Titleholder Address I I <br /> Job Address <br /> 1 Lot# I 1 <br /> Sub Division I Parcel # I I <br /> I <br /> n Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> 0 Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Bum n Hood Installation <br /> 0 Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> 0 Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> ratTyl emi (Jju _ <br /> Sprinkler ❑ ❑ ❑ E Recreational Bum <br /> Fire Alarm E ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning ❑ ❑ ❑ 1 1 n Sprinkler System Installations <br /> Hood Suppression Lz ❑ j ( ❑ ( 1 n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> E Fire Works <br /> E Flammable Application- ANNUAL I <br /> 0 Valuation of Project <br /> Fuel Tanks <br /> n Other: I <br /> Contractor I Company <br /> Signature Registered Y/ N J Fee Current I Y/ N <br /> Address I License # ( I <br /> ELECTRICIAN I Company <br /> Signature I Registered Y/ N I Fee Current 1 Y/ N I <br /> Address I <br /> 1 License # I I <br /> PLUMBER I Company I <br /> Signature J Registered ( Y/ N I Fee Current I Y/ N I I <br /> Address I ( ( I <br /> License # <br /> MECHANICALI I Company <br /> Signature I Registered Y/ N J Fe e Current 1 Y/ N I <br /> Address I I <br /> OTHER <br /> 1 License # I <br /> Signature I 10111100.-vi I Company vr1 • E � ?• <br /> Address I Registered wan Fee Current ird� <br /> Directions: I License # I ! �c9 tin% I <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 />