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813-780-0020 City of Zephyrhills Fire .� J I`1 � � Fax-813-780-0021 <br /> Permit Application <br /> Date Received s '� Phone Contact for Pertnit ���_i� <br /> k C� �v <br /> Owner's Name � C �/JfiP C7�0 � Owners Phone Number <br /> Owner's Address �f � ' f�{ e �� <br /> Fee Simple Titleholder Name TiUeholder Phone Number C� �� <br /> Fee Simple Titleholder Address <br /> , •:�Y °:..�x���:.<;s��.�:�����a.�. ..� .�.. -��':.r�a <br /> a.�'�m . , y . <br /> Job Address t � � � <br /> Lot # <br /> Sub Division Paroel # -� <br /> � � . .m� . ,. , at.e:��^:c'� ._ � . . .. . >o. . . ...:�:� .... „ q . . . ._.t,. .. . .,.. r., ,.� <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> a Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> � emi � er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ p � � Sparklers <br /> Hood Cleaning � O ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ O� � Standpipes (Sprinkler Sys) <br /> a Fire Alarm Installation � Toroh RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application-ANNUAL �- � Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> � , � � , , . �.r . . . ;�z c ;x" ;;�. _<�»e. , �. , ... . . . �• :..., , <br /> � ��. �. , .• .,�.,..;; .., .. . .' . - .. ,<.� "�� , <br /> . . .... . .. �e,.; , ..:n�:.». :a4R��'S&a��.:. .. : .a.r'. >:. . .. <br /> Contractor Company <br /> Signature C(..� N� `-- Registered Y/ N Fee Current Y/ N <br /> Address <br /> � License # � - (7Q�j J <br /> ELECTRICIAN Company <br /> Signature � Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER <br /> Company <br /> Signature Registered Y/ N Fee Curtent Y/ N <br /> Address <br /> License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: - - ., .. � . . . , , _ .. ..u. x .,. , _ . . . _ . F� .. <br /> Fiil 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 /> Ailow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />