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913-780-002o ity o Zephyrhills Fire <br /> Faz-813-780-0021 <br /> Permit Application <br /> )ate Received R - �'(,1 � (J(� �- / Phone Contact for Permit �L /� ��f � 35 , <br /> ?�csas.w^�-�::.:� �ar;ze.Y,.:�........_,.._.,,.,..w_,....�.,,�..�:��a�s3-�=^-� �r-�, �4..�s�- - - _ <br /> )wners Name �.C� / � � Owners Phone Number � � � �7� • / �� <br /> )wners Address `�: tr'� � /� � � / � �� � � / � <br /> ee Simple Titleholder Name Titleholder Phone Number �� � <br /> ee Simple Titleholder Address <br /> - -�-:„--�m*a��S''...,.'�°-�•`'''�� = em:-�i�+a -- F�...�:�'�,..�"�'' - `����'4� a�'s���=-"�a =E`�^u��'?�t����a�'�'.'�': <br /> ob Address L--IJ�� j/ J ��/ ' I J ��/ L�/ `� ��- �` Lot # � <br /> �ub Division Parcel # <br /> �Y rr��r,aR . <br /> - = --�� -== . <br /> � Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct a Hazardous Material (Tier 11 or RQ Facility� ANNUAL <br /> � Controlled Bum � Hood Instailafion <br /> a Emergency Generator < 30 kw " � LP/Natural Gas-Installation <br /> � Emergency Generatur > 30 kw � LP/Naturel Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL ��� <br /> r y emi �n er � � <br /> 5pri�kler � O ❑ ❑ � � Recreationai 8um <br /> Fire Alarm � ❑ � � � a Sparklers <br /> Hood Cleaning � �]° O ❑� a Sprinkler System Installa6ons <br /> Hood Suppression � ❑ ❑ D� � Standpipes (Sprinkler Sys) <br /> a Fire Alartn Installation � Torch RoofingfTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> � Other: _ <br /> '�=�°-=-- - - - •°.�.�m���-�ma�re��v�c+.� � ��, �--��. �--°°.-.�.�",�°� ..y� <br /> : ontractor _ _ /� Company L <br /> SignaWre �''�+i"�-� � Registered Y/ N Fee Current ` Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature Registered 1' / N Fee Current Y/ nl <br /> Address License # <br /> PLUMBER Company <br /> Signatu�e Registered Y/ N Fee Current Y/ N <br /> Address �— — I �icense # �— —� <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ nl Fee Current Y/ N <br /> Address License # <br /> Directio�s: <br /> RII ou[ application completely. <br /> Owner 8 Contractor sign back of application, nota�zed (Or, copy of signed contrect with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical work over 55000) <br /> Supply Mro (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review afler submittal date. Parcel #- obtained from PropeRy Tax Notice (http:!lappraiser.pascogov.com) <br />