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Ci of Zephyrhills Fire Fax-813-780-0021 <br /> 813-780-0020 ty <br /> . , . Permit Application <br /> iate Received � Phone Contact for Permit � <br /> ,,�.,_�-�.,:: ,�,..; ., :.,,, . .. , <br /> hnrner's Name / YS <br /> (f /�,QL e �,� c� vv' ers Phone Number �� ? ? J` S <br /> Tnmers Address 3 8�� 3� �� � v � � V�- r�` �(�S �C� • <br /> �ee Simple Titleholder Name Titleholder Phone Number �� �� <br /> =ee Simple Titleholder Address :,,��;;,��,� <br /> ,. � �; ��»� re ] ••.��{ _ _ _'�� F.FY..M4��. C� <br /> Lot # <br /> lob Address <br /> Paroel # <br /> 3ub Division . � � <br /> , � ,.: �S" � ,.r�:f'r , . . _ . '. .&?•r���';F ,> �TM�#� _ x.`:�'�7�° .�'�. - , - ' <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier It or RQ Facility) ANNUAL <br /> � Controlled Bum a Hood Installation <br /> a 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 /> ❑ �r 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 Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> a Fuel Tanks <br /> Q Other: _ <br /> a _ .:4.� ..� .�..�:��:,��-:-���;2 r,,.:�w . � _ �;��:,,� .,�.,:,.��:.��,-�.;..�������.a<k���. <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N 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 ' G v/'1 7 i C' <br /> Signature Registered Fee Current Y N <br /> Address License # G�U' � <br /> r <br /> Directions: <br /> Fill out application completely <br /> Owner 8 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:llappraiser.pascogov.com) <br />