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s�3aao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received �► r Phone Contact for Pertnit ��� <br /> C�ner's Name !� P �fj�'J/t Lr�" Owners Phone Number ��� <br /> 'C7v�mer's Address `rO2o� � — 13 � �- L e l^ �"l t � [ � L. 3 � <br /> Fee Simple Titleholder Name Titleholder Phone Number �� C� � <br /> Fee Simple TiUeholder Address <br /> < . �.� .��,a ���a��,=�:�� ra� .r.•- , �, _ , <br /> ,:^' . �- m. 4 b, k ^, `3.a�.��+.�.'.i'Y? 9 " , - , 0^�'�"•�&i'. ° nv;r ::1.' . ' ' . . <br /> Job Address � <br /> Lot # <br /> Sub Division Parcel # <br /> . . , . .. . , iWF�!' »»� .,., .. _ . .tYf,:a ......'r.i.$ y."'.<.s+.�.te,:.is. x a. < , x ^ .. � s. .. . :k.:l . a , <br /> . ., ..�.,�t,... �.��, .... . . . :, ra,. ,, ;'i::?i'r�:+�;i>:,�..as� y..g . '$i:=„✓. <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 Installatfon <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> a Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> ❑ �y emi �n er ❑ <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ O ❑�� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ p� � 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 /> ., , � ._ .m ..r.�r�. . � , , ,, :�.� �:,•:. , . �..... ,. .. _ <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 <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions .. ,_.. .. . .. . �. , <br /> Fill out application completely <br /> Owner & Contrector sign back of application, notarized (Or, copy of signed contract with ovmer) <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 (httpJ/appraiser.pascogov.com) <br />