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813-780-0020 City of Zephyrhills Fire Fax-813-780.0021 <br /> Permit Application <br /> D�e RacerCed I -1 Phone Contact for Pertnit �� � <br /> Owner's Name I-�Gl �,a.t�'� �,e L(� Owners Phone Number (� 3 ��� <br /> Owner's Address �d4 f'�' L ,�j�D � �, �� <br /> Fee Simple Titleholder Name Titleholder Phone Number C� �� C <br /> Fee Simple Titleholder Address <br /> Job Address � <br /> 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 /> a 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 Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning ❑ � ❑� � Sprinkler System Installations <br /> Hood Suppression ❑ � ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch 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 /> ' � t . � . . s,��:c .. . ....s�:.'atT'�;�3'x.w�.*,.,"tyz=s�.4'.:!Y:rFr`.., ,7r� ..etn,P,. .,.. >. . �.. ..�g�t�.�.a. ... �e �k -. . , .... <br /> COntfBCtOf <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER � Company �j �' � � <br /> Signature Registered N Fee Current N <br /> Address <br /> � �,„• , ,. „ t R License # rt ,�' LLL' <br /> Directions: .... _N,� . _ .,�, .. ..� �.. �.. .». ,...,,. A r .... ._.... , < . ,..�,...r....a»�,,:�L .w.».......�..�.....,,..�..,.. n. ,< < ,:.Y. t . <br /> Fi�l 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 />