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813 City of.Zephyrhills�Fire FaX-s�a-�ao-oo2� <br /> - Permit Application <br /> late Received T �� �� Q T��� Phone Contact for Permit � J [� <br /> :�a�::a^...a�,:x.; xra�_x�.::x...,..x.�.._,..�... - - -- � -- =�..:�:m�. �--�.�, __....--- <br /> )wners Name � �j�L Q �/��U �i / Owners Phone Number !� �3 J�S / .3 S� <br /> )wner's Addres�' +s / �t� ��1�"I�fi' �L_ 3 367� <br /> ee Simple Titleholder Name Titleholder Phone Number �� � <br /> ee Simple Titleholder Address <br /> ��t.� �� �� �;s_s..�� { - — - ���;-;�. <br /> ob Address �'�7��/�� W vI� 7��7 l�rL` �LVLJ. Lot # � <br /> �ub Division Parcel # <br /> � - �:: <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> Q Comm Exhaust Kitchen Hood/Duct a Hazardous Material �er II or RQ Facility) ANNUAL <br /> a Controlled Bum � Hood Installation <br /> a Emerc�ency Generetor < 30 kw a LP/Natural Gas-Installation ✓/�/ <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale �� `� <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL � I <br /> �y em� �n er <br /> Sprinkler � � ❑ ❑ � � Recreational Bum <br /> Fire Alarm � O ❑ O� � Spar{clers <br /> Hood Cleaning ��J � ❑� � Sprinkler System Instal�ations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofing(Tar Kettle <br /> Q Fire Pumps �. Waste Tire Storage ANNUAL <br /> � Fire Worics <br /> � Flammable Application- ANNUAL Valuafion of Project <br /> � Fuef Tanks <br /> � Other: <br /> �ontractor Company � � �S � �G- <br /> 5ignature � �� Registered Y/ N Fee Curtent Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> 5ignature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> P�UMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Add2ss <br /> License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Add2ss License # <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of applicatio�, notarized (Or, copy of signed contract with owner) <br /> If over 52500, a Notice of Comme�cement is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> AIIow 10-14 days for review after submittal date. Parcel #- ohtained from Property Tax Notice (http:!/appraiser.pascogov.com) <br />