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813-780-002D Gty of Zephyrhills Fire Fax-8�3-780-OC2t <br /> Permit Application <br /> Date Received � � _ _ Phone Contact fOr Permit �} �'�- q y Z � Li Ct 3 <br /> Owner's Name u � --� G , r � �� Z� �(/ <br /> � Owner's Phone Number �---�-1_LJ L%_G_�� � L <br /> � 35 Owner's Address P � <br /> Fee S�mple Titleholder Name Titieholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> , - - .._.. ._,. .:. - . ..�;_...:. : , :,._•....-:.. _: _ <br /> Job Address �j P z C (�� <br /> � J Lot # u <br /> Sub Division _ Parcel # i <br /> � Bio-Hazard W2Ste Storage - ANNUAL � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Comm Exhaust Kitchen Hood/DuCt � Hood Installation � <br /> � Controlled Burn Q LP/Natural Gas-Instaliation ' 1 �� <br /> � Emerqency Generator < 30 kw � LP/Natural Gas-ANNUAI Sale �� <br /> � Emergency Generator> 30 kw �---� � n places ofAssembly-ANNi.I.q! <br /> � Hre ProFeCUOn Maintenanc � AL � � <br /> Recrzationa� ourn <br /> try emi � e� ❑ <br /> Sprinklei � � � � <br /> Sparklers <br /> Fire Alarm ❑ ❑� � Sprinkler System Installations <br /> Hood Cleaning ❑ ❑ 17 ❑ Standpipes (Sprinkler Sys) <br /> Hood Suppression � � ❑ O�� ❑ Torch RoofinglTar KEttle <br /> � Fire Alarm Installation � Waste Tire Storage ANNUAL <br /> ❑ Fire Pumps <br /> � Fire Works <br /> � Fiammable Application- ANNUAL �� <br /> ❑ Valuation of Project <br /> Fuel Tanks <br /> Q Other <br /> Contractor .. .. , -- - -- - - ._. ,__.,: - .-_ -= °- ° - - <br /> Company - T-- <br /> Signature � <br /> Registered Y/ N Fee Current Y/ N <br /> �aaress 3g31 Vte �on �icense# q <br /> �3538000 �2po�, � <br /> cLECTRfCIAN <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER <br /> Signature <br /> i,ompany <br /> Registered Y/ Pd Fee Current Y/ N <br /> Address <br /> license # <br /> MECHANICAL _ <br /> Signawre <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> license # <br /> uTHER ; <br /> Sigra'ur� � Company --� <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> Cirec;�ons. _ -. _ . . <br /> License # <br /> Fill out application COmpietely <br /> Owner 8 COntractor sign back of appiication, notarized (Or, copy of signed contract with owner) <br /> If over 52500, a Notice of Commencement is required (Mecharncal work over $S0o0) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allo�,v 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:l/appraiser pascogov com) <br />