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" - 813 -780 -0020 City of.Zephyrhills Fire Fax- 813780 -0021 <br /> ' -Permit Application <br /> Date Received I Z fa, I 0 Phone Contact for I ?> 1 7,1? -0' <br /> Owner's Name l 1-\\ L.L' - 1 \ i ` U Z- Owner's Phone Number l <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitleholder Address 1 <br /> Job Address , 3g'i \ c: At3E ZES 0 \1-1 -5 3 51- Lot# <br /> Sub Division Parcel # <br /> ED Bio-HazardWasteStorage - ANNUAL Jn Fumigation Tent <br /> J-I Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> ri Controlled Bum n Hood Installation <br /> Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> E l Emergency Generator> 30 kw J-I LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> 1QtriyI isemil 011 'Other <br /> Sprinkler ❑ ❑ n Recreational Bum <br /> / <br /> Fire Alarm N ❑ ❑ ❑ I I n Sparklers il'S-' <br /> Hood Cleaning n ID ❑ ❑ J I n Sprinkler System Installatio s <br /> Hood Suppression Ej ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> 0 Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> H Fire Pumps 1 Waste Tire Storage ANNUAL <br /> Fire Works <br /> n Flammable Application- ANNUAL I I Valuation of Project <br /> Jn Fuel Tanks <br /> n Other: <br /> Contractor Company � 'Pi4 �) fZ - e � L�' D/� <br /> Signature "`L Registered Y / N j Fee Current I Y / N j <br /> Address J ?j L. 1,/,.= �� Ll; c Auk TA TY/ Pr ' FL ? I Z License # r!i�j' f <br /> ELECTRICIAN Company <br /> Signature J Registered Y / N 1 Fee Current ( Y / N j <br /> Address I I License #. <br /> PLUMBER Company <br /> Signature Registered Y/ N J Fee Current 1 Y/ N <br /> Address J I . License # ( I <br /> MECHANICAL Company <br /> Signature Registered Y / N ( Fee Current ( Y / N J <br /> Address J I License # <br /> OTHER Company <br /> Signature Registered Y/ N J Fee Current ( Y / N J <br /> Address License # <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 />