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���-�ao-oozo City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received $ l0 `/ Phone Contact for Pertnit $ � 3 `�9 6 6 S/6 9 <br /> Owners Name ��/'ST c� �( (/�v/'(�t d1' Le /'lic r�� Ovmers Phone Number 8� � S,$�7y <br /> Owner's Address ,3 � Z- �! S �` 33 �� 2 <br /> Fee Simple Titleholder Name Titleholder Phone Number ��� <br /> Fee Simple Titleholder Address <br /> g . � _:f.. ,� t, � <br /> Job Address ,S�YI.-�i& � <br /> Lot # <br /> Sub Division Paroel # <br /> , ,_ ., , , _. � ..... .,. . . ,. .. �. . . <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � 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-ANNU �� G/ <br /> �y emi �n er � / <br /> Sprinkler � O ❑ ❑ � � Recreational Bum / <br /> Fire Alartn ❑ ❑ ❑ S arkle � <br /> � � <br /> P � <br /> Hood Cleaning � O ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression /� ❑ � ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch RoofinglTar 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 /> Contractor Company �' � F' �, � G <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address P D. `.c,�. O'� 63 License # <br /> ELECTRICIAN Company <br /> Signature I 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 <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: <br /> Fill out application completely <br /> Owner 8 Contrector sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical woric over $5000) <br /> Supply Mro (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 />