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813- 780 -0020 City of Zephyrhills Fire <br /> i ((�i S Fax-813-780-0021 <br /> Permit Application (t 1 <br /> ate Received Phone Contact for P ermit j Q f 3 I J ' OI 11 63 " --7 5 1 <br /> wner's Name c. V 1 It O S I I 1 1 1 1 I <br /> Owner's Phone Number <br /> wner's Address I 1 4'7 4.1 Si L v E v._ C 12c I <br /> 3e Simple Titleholder Name 10.) Po I I 1 1 I 1 I <br /> Titleholder Phone Number <br /> 3e Simple Titleholder Address I <br /> tb Address I <br /> Lot # I I <br /> Jb Division I I Parcel # <br /> Bio <br /> Hazard Waste Storage - ANNUAL I ---- I Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct EJ Hazardous Material <br /> ri <br /> (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum Hood Installation <br /> n Emergency Generator < 30 kw = LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw I-1 LP /Natural Gas - ANNUAL Sale <br /> ED Fire Protection Maintenance - ANNUAL <br /> ❑ Zi� I I laj M � Places of Assembly- ANNUAL <br /> Semi �• <br /> Sprinkler ❑ ❑ ❑ I—I Recreational Bum <br /> Fire Alarm E ❑ ❑ ❑ I 1 E Sparklers <br /> Hood Cleaning 0 ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ I I El Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation f Torch Roofing/Tar Kettle <br /> n Fire Pumps = Waste Tire Storage ANNUAL <br /> El Fire Works <br /> Flammable Application- ANNUAL I <br /> Fuel Tanks <br /> I Valuation of Project <br /> Q Other: I <br /> Dntractor •. . , <br /> gnature �t 1 Company <br /> Registered I Y/ N J Fee Current I Y/ N I <br /> Address I I <br /> License # I <br /> _ECTRICIAN <br /> gnature I I Company I <br /> Registered Y/ N I Fee Current I Y/ N,I <br /> Address I <br /> .UMBER I License # I I <br /> nature I I Company <br /> Registered Y/ N I Fee Current I Y / N I <br /> Address I <br /> :CHANICALI I License # I <br /> mature I Company <br /> Registered Y / N I Fee Current I Y / N j <br /> Address I I <br /> License # I <br /> HER <br /> nature I Company I <br /> Registered Y/ N I Fee Current I Y/ N <br /> Address I I <br /> actions: <br /> License # <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 />