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813- 780 -0020 City of Zephyrhills Fire <br /> Fax - 813 -780 -0021 <br /> Permit Application <br /> Datt Received 1 1 Phone Contact for Permit I I I I I <br /> Owners ame I 451...;\'4, l -3 A ph f tS 1 Owner's Phone Number <br /> Wmer's ddress 13 k64/ ( J A ) , P1 . 11 , o <br /> Fee Simple Titleholder Name I 1 Titleholder Phone Number I 1 1 11 <br /> Fee Simple Titleholder Address I <br /> Job Address I I <br /> I Lot # <br /> Sub Division 1 Parcel # I <br /> ED El Bio-HazardWaste Storage - ANNUAL I Fumigation Tent <br /> Comm exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> 0 Controlled Bum I Hood Installation <br /> n Emergency Generator < 30 kw r LP /Natural Gas - Installation <br /> El Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale <br /> J — I Fire Protection Maintenance - ANNUAL P laces of Assembly- ANNUAL <br /> Rays ems mul mom <br /> Sprinkler 1� ❑ ❑ ❑ 7 Recreational Bum <br /> Fire Alarm El ❑ ❑ ❑ I I 7 Sparklers <br /> Hood Cleaning L1 ❑ ❑ ❑ I I 7 Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ I J J1 Standpipes (Sprinkler Sys) <br /> r-I Fire Alarm Installation = Torch Roofing/Tar Kettle <br /> Fire Pumps El Waste Tire Storage ANNUAL <br /> Fire Works <br /> E Flammable Application- ANNUAL I I <br /> Valuation of Project <br /> I Fuel Tanks <br /> Q Other: I <br /> Contractor <br /> o j (1 9. 4 � }, Company <br /> Signature I I `� I Registered Y/ N ,I Fee Current I Y/ N I <br /> Address I I License # I <br /> ELECTRICIAN I Company <br /> Signature I <br /> Registered Y/ N I Fee Current I Y / N J <br /> Address I I License # I <br /> PLUMBER I I Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address I I License # <br /> MECHANICAL! Company <br /> Signature I Registered Y/ N J Fee Current 1 Y/ N I <br /> Address I <br /> 1 License # <br /> OTHER I I Company <br /> Signature Registered Y/ N _I Fee Current I Y/ N 1 <br /> Address I <br /> .. , .,.. <br /> 1 License # <br /> 1 <br /> Directions: <br /> Dirac <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 />