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s� s�ao-oozo City of Zephyrhills Fir:e• Fax-s13-7eo-oo2� <br /> Permit Application <br /> Date Received G' 7' /� Phone Contact for Permit �3 3? a'4 <br /> Owner's Name !�tJ �'ti J� ��.S Owner's Phone Number .� � C <br /> ner'sAddress � (�"J �� l►T ' l.��JL�'� (�.K ���: � T� 3�T3 <br /> Fee Simple Titleholder Name Titieholder Phone Number �� C <br /> Fee Simple Titleholder Address <br /> Job Address �� l{ � S �' • � � � c �� � �/ ��`� /�' Lot # � <br /> Sub Division Paroel # ' Z � 2 " U� �� U V� �� �"` <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Q Controlted Bum � Hood Installation <br /> � Emergency Generator < 30 kw a LP/Natural Gas-tnstallation <br /> � Emergency Generator> 30 kw a LP/Natural Gas-ANNUAL Sale <br /> • � Fire Protection Maintenance - NNUAL � Places of Assembly-ANNUAL <br /> y emi � er <br /> pnn er / ❑ � a Recreational Bum <br /> ` Fire Alarm � ❑ Q�' / � Sparklers <br /> Hood Clean' g � C�.%� ❑ �� � SprinklerSystem Installations <br /> Hood Suppress �� � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> Fire Alarm Ins � � Toroh RoofinglTar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> � Flammable Application- ANNUAL �' Valuation of Project <br /> Fuel Tanks <br /> � Other: <br /> Contractor � Company �cJr( �'�'u ��- <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address � Ld �T/_3 � License # �� •v� I( <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/ IV <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Curre�t 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 application completely. <br /> Owner 8 Contractor sign back of application, notarized (O�, copy of signed contract with owner) <br /> if over $2500, a Notice of Commencement is required (Mechanical woric 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 (httpJ/appraiser.pascogov.com) <br />