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a 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received ,� �O �� Phone Contad for Perrnft �� q 3a � �� <br /> Owner's Name � Owners Phone Number �� � S� <br /> Owners Address � � - r h 1� � J� � <br /> Fee Simple Titleholder Name Titleholder Phone Number �� �� <br /> Fee Simple TiUehotder Address <br /> Job Address � �' V`J --- 38 I 30 �'e Q7� � F t# � <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm F�chaust Kitche� Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> a Controlled Bum a Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw � LPMatural Gas-ANNUAL Sale <br /> � Fire Protedion Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y mi � er <br /> G�I� � Sprinkler � O ❑ ❑ � Recreational Bum /' <br /> � �/�r1)1' Fire Alartn � ❑ ❑ ❑ � � Sparklers I � I <br /> �'�� '� (' � jr <br /> ^� ��� m Hood Cleaning �❑ 0 ❑ � Sprinkler System Installations � �I/ <br /> Vu Y Hood Suppression �/ ❑ ❑ ❑� S� Standpipes (Sprinkler Sys) � <br /> J� <br /> � Fire Alartn Installation Q Torch Roofing/Tar 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 /> Contractor /, '��� G � � ' � O �, �/� �� Company <br /> Signature �� � �� Registered Y/ N Fee Current Y/ N <br /> /�/y�('.iddress — License # <br /> � . .�'�� �R � <br /> ELECTRICIAN Company <br /> Signature Registered Y/ nl Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: <br /> Fill out appliption completely <br /> Owner & Contrador sign back of application, notarized (Or, copy of signed contract with ownerj <br /> If over $2500, a Notice of Commenoement is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documer�tation <br /> Allow 10-14 days for review after submittal date. Paroel #- obtained irom Property Tax Nodce (http://appraiser.pasvogov.com) <br /> VIGIL INC � <br /> H� ���,� �,�. G� � I► ac� <br /> po.�rr�n•��,,�� � <br /> P: 813-�1►-�fi0 F: i13-S33-A�g � <br /> g�Oi'�eway@aol.com <br />