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s13-780-002o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Rec�ived • �( y � Phone Contact for Pertnit � C � 7 _1' Q � <br /> wner's Name �— T' /�f � F Owner's Phone Number �] �� 0�, ��- <br /> wner's Address ?�( S (S�1 �� 2� r h � �S FL �j ?j�, Z.. <br /> �e Simple Titleholder Name Titleholder Phone Number C� � I I <br /> �e Simple Titleholder Address <br /> u <br /> �b Address W� l� �( f� 3 7 tJ l� �� F iv !� h rh � I S� Lot # Z�� <br /> �J <br /> �b Division ParCei # <br /> � Bio-Hazard Waste Storage - ANNUAL a Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Comm F�chaust Kitchen Hood/Duct � Hood Instal�ation <br /> � Controlled Bum a LPMatural Gas-Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � � � <br /> Emergency Generator > 30 kw Places of Assembly-ANNUAL !� c� <br /> � Fire Protection Maintenance - ANNUAI � Recreationai Bum �� `"� <br /> ❑ � emi � er <br /> � _ 1 ,,` `L (,� Sprinkler ❑ ❑ ❑ � � Sparklers <br /> C.1'1CGµ' <br /> Fire Alartn � ❑ ❑ ❑� � Sprinkler System Instatlations <br /> 1 �` � ��! np �F�lood Cleaning ❑ ❑ ❑ � Standpipes (Sprinkler Sys) <br /> � � �� � Hood Suppression ❑ � ❑ � � Torch Roofing/Tar Kettle <br /> � Fire Alarm Installation a Waste Tire Storage ANNUAL <br /> � Fire Pumps <br /> � Fire Works <br /> � Flammable Appiication- ANNUAL <br /> � Vaivation of Project <br /> Fuel Tanks <br /> � Other <br /> �ntractor �/�) � 1 , / <br /> gnature " — � � �� l/ � � � L� / / Company <br /> ��N R istered Y/ N Fee Current Y/ N <br /> �In��S,(d�ss <br /> �3 � �� # <br /> _ECTRICIAN <br /> gnature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> _UMBER <br /> gnature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> ECHANICAL <br /> gnature <br /> Company <br /> Registered Y/ N Fee CuRent Y/ N <br /> Address <br /> License # <br /> THER <br /> gnature Company <br /> Registered Y/ N Fee CuRent Y/ N <br /> Address <br /> License # <br /> �2ctions: <br /> Fill out application completely <br /> Owner & Contractor sign back of appliption, notarized (Or, copy of signed contract with owner) <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. Parcei #- obta(ned from Property Tax Notice (hrip://appraiser.pascogov.com) <br /> n1�i,�,tr�, VIGIL INC <br /> � He�rd !� Ex� t�aia� Svc. <br /> P.O. smt 27'37�?' "'i�, �t � <br /> P: 613-932 91M F: i19-� <br /> gatorallC6rwa�►�a�l.cem <br />