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8 City of Zephyrhills Fire Fax - 813 - 780 -0021 <br /> i <br /> Permit Application <br /> ate Received � ®,�fila Phone Contact for Permit <br /> I1 1 1 <br /> wner's Name 1 Mies .44 y Clut4 cA. I Owners Phone Number I 1 1 I <br /> wner's Address I I <br /> se Simple Titleholder Name 1 J Titleholder Phone Number 1 1 1 I I <br /> .le Simple Titleholder Addrgac _1 <br /> rb Address T/ 9, z/ ci t 411 - Lot # <br /> _lb Division 1 Parcel # I I <br /> D Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Ei Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Bum n Hood Installation <br /> IT Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> ii Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sal <br /> Fire Protection Maintenance - ANNUAL n Plac of Assembly -ANN • • L !LIMY' UM r i L T 4((q Sprinkler ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm ❑ ❑ X I 1 E Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I 1 n Sprinkler System Instal = ions <br /> Hood Suppression D ❑ ❑ ❑ I 1 El Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> I—I Fire Pumps n Waste Tire Storage ANNUAL <br /> L1 Fire Works <br /> El Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> El Fuel Tanks <br /> Q Other: 1 <br /> Dntractor Company I <br /> gnature Registered Y/ N I Fee Current I Y/ N <br /> Address I I License # I I <br /> _ECTRICIAN .Q `- �/� Company r- /e EJeclsic <br /> gnature I / o# / e S 7ec /r . i. ! �! A7 I " d Registered 1b� Fee Current r uses <br /> Address I , ? /// A.-7 .e 2 i / G/ License # <br /> - C��t �! �s 3 I ( t r e.,,000 /ZL,9" I <br /> _UMBER Company I <br /> gnature Registered I Y/ N I Fee Current I Y/ N I <br /> Address I I License # <br /> ECHANICAL Company <br /> gnature Registered Y/ N I Fee Current I Y/ N j <br /> Address I I License # I I <br /> THER Company I <br /> gnature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> rections: , <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 />