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813- 780 -0020 City of Zephyrhills Fire Fax- 813 -780 -0021 <br /> Permit Application <br /> Date Received I 1 Phone Contact for Permit I 1 1 1 1 <br /> / ,J ' ( !i I O Phone I <br /> Number _. . <br /> Owner's Name 7A (/re 8'13 I 7 8-42 I I <br /> Owner's Address 1 3J ? / / // 4' ZIoly h' x' <br /> Fee Simple Titleholder Name I Titleholder Phone Number I <br /> Fee Simple Titleholder Address I <br /> Job Address I Lot # <br /> Sub Division I I Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> El Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Bum I-1 Hood Installation <br /> El Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> I - ) Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> El Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL <br /> ry Semi) Cal Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm 0 ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning D ❑ ❑ ❑ ( I I] Sprinkler System Installations <br /> Hood Suppression ❑ y_ ❑ I 1 n Standpipes (Sprinkler Sys) <br /> 7 Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> El Fire Pumps n Waste Tire Storage ANNUAL <br /> E Fire Works <br /> El Flammable Application- ANNUAL ( I Valuation of Project <br /> I - I Fuel Tanks <br /> Q Other: <br /> Contractor Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address 1 I License # I <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N I Fee Current I Y/ N I <br /> Address 1 I License # I I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N 1 <br /> Address I ( License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N <br /> Address I I License # I I <br /> Company , _ r K xA i •0•^N T • L LC <br /> Signature -7el Registered WE. Fee Current 'MIN <br /> Address 1 I License # I 7 ,s're190 0 li <br /> ,79 ... .e . _.. . <br /> Directions: ,. - ..- .0 a. ate . . .... .... ... ... <br /> _. <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 />