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g13-780-0020 <br /> City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received Phone Contact for Permit T q � <br /> � , �.. »; �.,- ,�.-: ., � � . . � <br /> wner's Name �i G. �✓�*��v Owners Phone Number ��� <br /> avner's Address ,3�0� 7� �L �� h � v� e '� K 2� h�� S <br /> ee Simple Titleholder Name Titleholder Phone Number ��� �� <br /> ee Simple TitleholderAddress �.-,,.P. � <br /> , � x - - -� � � ��s���.,�•�+.�,� " C� <br /> Lot # <br /> ob Address <br /> �ub Division Parcel # <br /> � ,- k.,e; ,.. ., , <br /> � ��:-°•�;sm _N. a�� < .-u��+?��..�.����«., <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw a LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw a LP/Natural Gas-ANNUAL Sale <br /> a Fire Protection Maintenance - ANNUAL a Places of Assembly-ANNUAL <br /> ,C4�Tr y emi �n er ❑ <br /> Sprinkler � ❑ ❑ � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ �� � Sparklers <br /> Hood Cleaning � ❑ � ❑ L� � Sprinkler System Installations <br /> Hood Suppression � ❑ J� ��� � 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 /> � Fuel Tanks <br /> Q Other: , <br /> k . 8=0..,�.�.s.,,e;;.;,..a��kia`a�.,.a':M:"::�::.'a�,§M13�WK'4.+��Af,'3c'#�:.�'n =�`a.'�:;d[:�4&'.:_,�::i...,.;'z.?-.�'�«',,aK�r..a'raef:5s�'�,��t,R4S:,aY�.� , _ 3�" .,:rr,` <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 �✓,-� T .e � �.,,, GLC' <br /> Signature Registered Fee Current Y N <br /> Address License # 7�� �.$ / 9li <br /> � <br /> Directions: <br /> Fill out application completely <br /> Owner & 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://appraiser.pascogov.com) <br />