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813 ` �-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received ,S� Q U G �U L J.Il,� Phone Contact for Pertnit �� �� <br /> Owner's Name ��� t�L �� l �S �L ��� `� ��' !� Owner's Phone Number g(,3 �Qj 3 L� J <br /> Owner's Address � � U / J �,U � � <br /> Fee Simple Titleholder Name TiUeholder Phone Number ���� <br /> Fee Simple Titleholder Address <br /> Job Address % 3 J a I YL �/y ��, �j rL �� f jt �[, 3j ,S Lot # � <br /> Sub Division Parcel # <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 /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ - ❑ � Recreational Bum <br /> Fire Alarm � ❑ � ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ � ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> a Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> . , , - . . .. � . . �, . a , ..� � � . .. �. <br /> Contractor . Company � �� V t � <br /> Signature � �/ Registered Y/ N Fee Current Y/ N <br /> Address g G i � {v� �� �' � m,Q License # p <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Cu�rent Y/ N <br /> Address License # <br /> MECHANICA 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 /> Directlons: ` .. . . . . . . , .. . ... . - ,.. �.�... . ,.. ,. <br /> Fill out application completely <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contrect 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 />