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813-780-0020 Clty ofZephyrhills Fire• i?/� �� Fax-813-780-0021 <br /> PeRnit Application '� <br /> �'," � n <br /> �ate Received • 7 V� / /�. 7 �/ Phone Contact for Pertnit �" ,� ��,_.��� <br /> :35::ar���:.�i.X����:. �,.:u......�..,.,.,.�...��.:..�� °*�swi ��-- � s -- sa^.�+,..T��i.� - ,sr - '� - �^'���us�" - - -.. . . _ ._ . . _ <br /> )wners Name �2 Owners Phone Number LS I J �7 • `�-S/ <br /> )wners Address � �• �O/ � % / � �� � '�� ��� � � <br /> ee Simple Titleholder Name Titleholder Phone Number ��� �� <br /> ee Simple Titleholder Address <br /> r:�r-+mcm. r��s�+mxi+x,�"Nt'.�c*.�'+r.• - . . .r�.�-e3 --a..��.�x'r� ua'�'—. si's' �-' <br /> � �'��: � � av�.`� Y`s�+�..-._ �::. - <br /> ob Address �� � "' L �L1• Lot # � <br /> �ub Division <br /> Parcel # <br /> �t � -i,tZs...i�"..+R.�`. , - . . <br /> � a. .e — -- ,�rs.t ���.�t�.�v._-3i <br /> a Bio-Hazard Waste Storege - ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazatdous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installa6on <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generetor > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> a Fre Protection Maintenance - ANNUAL � Places of Assembly-AIvNUAL <br /> r y emi �n er <br /> 5prinkler � ❑ � � � Recreational Bum <br /> Fire Alarm � ❑ � � � � Sparklers <br /> Hood Cleaning � 4y ❑ ❑ � a 5prinkler System Installations <br /> Hood Suppression � ❑ ❑ � � � Standpipes (Sprinkler Sys) <br /> � Fire Alami Installation � Torch RoofingfTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> a Fire Worlcs <br /> a FlammableApplication-ANNUAL ValuationofP�oject <br /> � Fuel Tanks <br /> � Other: <br /> �,m� �..�.����� - - °' <br /> �ontractor � /, Company <br /> Signature "'� Registered Y/ N Fee Curre�t Y/ N <br /> Address License # <br /> ELECTRICIAN Compa�y � <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Regis[ered �' / I�I Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/(�I Fee Current Y 1 N <br /> Address License i� <br /> OTHER Company <br /> Signature Registered �' / N Fee CuRenl 1' / N <br /> Address License � <br /> - - - aass xb. �_rr � -_s�--.^�'� k - <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (�r, copy of signed contract with owner) <br /> If over 52500, a Notice of Commencement is required (Mechanical work over 55000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow ta-14 days for review afier submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />