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813- '0 -0020 City of Zephyrhills Fire Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received I I Phone Contact for Permit I 11 I <br /> Owner's Name 1 (> S C S I Owner's Phone Number 11 13 117h) II OOP, <br /> Owner's Address I 'sQ S o i/ p /oes z y ,-/, /IS ,' <br /> Fee Simple Titleholder Name I 1 Titleholder Phone Number I 1 I <br /> Fee Simple Titleholder Address I <br /> Job Address 1 Lot # <br /> Sub Division I Parcel # I I <br /> El 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 /> Ej Controlled Bum pi Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> Emergency Generator> 30 kw II LP /Natural Gas- ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> ry !Semi' rail MEM <br /> Sprinkler 0 ❑ ❑ ❑ I Recreational Bum <br /> Fire Alarm 0 ❑ ❑ ❑ I I 17 Sparklers <br /> Hood Cleaning A. ❑ ❑ I 1 I] Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ I 1 I] Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> ri l Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> n Flammable Application- ANNUAL ( 1 Valuation of Project <br /> I] Fuel Tanks <br /> Q Other: I I <br /> Contractor Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N 1 <br /> Address I I License # I <br /> ELECTRICIAN Company I <br /> Signature I Registered Y/ N I Fee Current I Y/ N I <br /> Address I License # I <br /> PLUMBER Company I <br /> Signature Registered Y/ N 1 Fee Current 1 Y / N I <br /> Address ( 1 License # I I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N 11 <br /> Address I 1 License # ( <br /> OTHER vPy� �. EQdi 01-7701-77- Signature Registered DOM Fee Current Irtkillr.11 <br /> Address I I License # 171)941/45"7-00a40r04 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 />