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e�3-780-0020 � _ � ��l ( City ofZephyrhills�Fir:e Fax-eis-�so-oo2i <br /> � , Permit Application <br /> late Received � �� � o D � L-- - Phone Contact for Pertnit � r�� C%'J-�! � <br /> :33o4:F�%v'�".w;i'���Sr;�r,,:....... _.=....tv - =3�.�'� 5s is b� - - - --�.�...,...du ....... ......�__ <br /> )wners Name � G / f / � ��� � �� � <br /> �. - � j p Owners Phone Number �� � - � <br /> )wners Address � � � ��/ � �✓ �( ��/ "� � J � V / <br /> ee Simple Titleholder Name Titleholder Phone Number �� �� <br /> ee Simple Titteholder Address <br /> �„�.�-Y._��:-�-�,�'+;"=`:•.__-�''=�r�-�t-+mc�c":1Gd�Y��'s� - _.;,�.3£�•°-�f�:�'�" <br /> _,,,,�.' ..`�=`"�=y�-'��-�` ' "�� �'=:. <br /> ob Address -� L�� Lot # U <br /> �ub Division c Parcel # <br /> �'_+�� - <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> a Controlled Bum a Hood Installation <br /> � Emergency Generetor < 30 kw � a LP/Natural Gas-Installation <br /> a Emergency Generator > 30 kw � LP/Nawrel Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> r y emi � er � ' <br /> Spri�kler � ❑ O ❑� a Recreational Bum i � <br /> Fire A�artn � ❑ ❑ ❑ � a Sparklers ��'� <br /> Hood Cleaning �❑ E:3� ❑� � Sprinkler System Installafions �� <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys] <br /> � Fire AIaRn Installation � Torch RoofinglTar KettJe <br /> � Fire Pumps � �Naste Tire Storage ANNUAL <br /> a Fire Worlcs <br /> a Fiammahle Application- ANNUAL Va�Uafi0fl Of PfOJECt <br /> a Fuef Tanks <br /> � Other: <br /> - ��+ � �, <br /> : ontractor / Company <br /> Signature CJ�'� Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature Registerad l� / N Fee Current Y/ N <br /> Address License � <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee CuRent Y/ N <br /> Address License # <br /> MECHANICAL � Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER Company <br /> Signature Registered �' / N Fee Current Y/ N <br /> Address License # <br /> Directions: <br /> ' - - - - - �s�.,� - - � <br /> Fill ou[ application completely <br /> Owner 8 Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over 52500, 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 />