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813- 780 -0020 City of Zephyrhills Fire <br /> Fax- 813 - 780 -0021 <br /> Permit Application <br /> Date Received f 1 1 1 I I I <br /> Phone Contact for Permit I <br /> Owner's Name PRY; ,iiil // <br /> - �-- �/� ��� � �L� Owner's Phone Number <br /> 10 Owner's Address (,Tc?',,� � ..-.1r:71—eI <br /> Fee Simple Titleholder Name I I I <br /> Titleholder Phone Number I I I 1 1 I <br /> Fee Simple Titleholder Address I <br /> Job Addr I <br /> ess I <br /> I I Lot # I I <br /> Sub Division I Parcel 1 <br /> Pael # <br /> Bio -Hazard Waste Storage - ANNUAL n <br /> 0 Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct E=1 Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum Hood Installation <br /> ED Emergency Generator < 30 kw ED LP /Natural Gas - Installation <br /> Fl Emergency Generator> 30 kw a LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL <br /> Places of Assembly- ANNUAL <br /> 1Qtrly] 'Semi] usji moil <br /> Sprinkler EJ ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ I 1 El Sparklers <br /> Hood Cleaning D ❑ ❑ ❑ I 1 n Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ ❑ I I LJ Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation r-i Torch Roofing/Tar Kettle <br /> 71 Fire Pumps = Waste Tire Storage ANNUAL <br /> R Fire Works <br /> Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> Fuel Tanks <br /> E] Other: I <br /> Contractor Company I <br /> , Registered Y / N I Fe e Curr ent Y / N Addres <br /> License # I <br /> ELECTRICIAN <br /> Signature I Company <br /> Registered Y/ N J Fee Current I Y/ N I <br /> Address I <br /> PLUMBER I License # I <br /> I Company I <br /> Signature Registered Y/ N Fee Current I Y/ N <br /> Address I I I <br /> License # I <br /> MECHANICAL' I <br /> Signature Company I <br /> Registered Y/ N . Fee Current 1 Y/ N I <br /> Address I I <br /> License # I <br /> OTHER <br /> Signature <br /> Company I <br /> Registered Y/ N I Fee Current I Y/ N j <br /> Address ( I <br /> 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 />