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813- 780 -0C20 City of Zephyrhills Fire Fax - 813- 780 -0021 . Permit Application Date Received I / Z/2 / 4 / / � gait/ 8. `� I Phone Contact for Permit / 3 1 1 y/ 1 U j . 3 Owner's Name //e--- 0/ _ /7' e c--I Z°_/7 / I O Phone Number 1 Owners � I III Address 1 2 e_/ yr ,y Fee Simple Titleholder Name I I 1 1 1 Titleholder Phone Number l Fee Simple Titleholder Address I Job Address 1 ` 0 —12 -- /5 / < 4 2 e fXyI / .-. /75 I I Lot# Sub Division I 1 Parcel # I 7 Bio-Hazard Waste Storage - ANNUAL Fumigation Tent I I Comm Exhaust Kitchen Hood/Duct Hazardous Material (Tier II or RQ Facility) ANNUAL n Controlled Bum Hood Installation El Emergency Generator < 30 kw a 7 LP /Natural Gas - Installation Emergency Generator> 30 kw LP/Natural Gas - ANNUAL Sa 0 Fire Protection Maintenance - ANNUAL I Places of Assembly -ANN AL ❑ r y Wits l:�1 [IJ 1 / I ' / Sprinkler ❑ ❑ ❑ _ ] Recreational Bum < , L Fire Alarm 4 . ❑ ❑ I I El Sparklers Hood Cleaning ❑ V ❑ I I Sprinkler System Installations Hood Suppression ❑ ❑ ❑ I I 0 Standpipes (Sprinkler Sys) n Fire Alarm Installation I Torch Roofing/Tar Kettle n Fire Pumps = Waste Tire Storage ANNUAL ED Fire Works Ej Flammable Application- ANNUAL I Fuel Tanks I Valuation of Project Q Other: I Contractor Company Y y Signature ��, / 7 - -A-1/' / fr, ss LJ, ri, Registered I Y/ N _1 Fee Current I Y/ N I Address I , 5 E -, :ter/ cl i.,i.714 i 1 r' ( 1../et 57 -7— ` _ V ( I ELECTRICIAN I Signature I Company Registered ¥ / N Fee Current I Y/ N Address I I License # PLUMBER I I Company Signature Registered Y/ N J Fee Current I Y/ N I Address I I License # MECHANICAL! I Company Signature Registered Y/ N 1 Fee Current I Y/ N J Address I I I License # OTHER I I Company Signature Registered Y/ N J Fee Current 1 Y/ NJ Address I License # 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 (http: / /appraiser.pascogov.com)