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s13-��aoozo City of.Zephyrhills Fire Fax-813780-0021 <br /> 1 ' Permit Application <br /> Date Received Phone Contact for Permit <br /> '•:x'� . .. n:.:..u.mu.:,.,,..«,ww».w.s,.�.uw...x� w.« w..:w....e�.,..,.e ....,�a....,.e...�w.� <br /> Owner's Name Q �S � rp Owners Phone Number S/ 3 7 8 3 38 7 7 <br /> Owner's Address / G�7 W �1� Q�V(� Z�PJf yj��rG L 5 /—� • <br /> Fee Simple Titleholder Name TiUeholder Phone Number �� �� � <br /> Fee 5impieTitleholderAddress <br /> ��'?' . <br /> // � <br /> Job Address �'7 �p �/Q-�L �L(J� Z L,^J%�7� lT�'�G s f—C – Lot# �� <br /> Sub Division Parcel# <br /> ;s•a�, <br /> N% � 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 Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> ❑� emi � er � <br /> Sprinkler p ❑ ❑ RecreationalBum _`��–,CT��L�+ �6�"'�E� <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers ��Q– �p/ � <br /> Hood Cleaning � ❑ �q/ ❑ � � <br /> Sprinkler System Installations � � <br /> Hood Suppression � D ❑ ❑ �� � Standpipes(Sprinkler Sys) �' v <br /> � Fire Alartn lnstallation � Toroh Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Ftammable Application-ANNUAL /S Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> :�: <br /> Contrector � � Company -� = /ZC(/��(J'("Sv .$ �� <br /> Signature �� Registered /N Fee Current /N <br /> Address ,B�QQ LJ (QA � � � � [. 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 <br /> License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> Directions <br /> Fill out application completely <br /> Ovmer&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$25D0,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drewings with applicable documentation <br /> Allow 10-14 days for review after submittai date. Parcel#-obtained from Property Tax Notice(http://appreiser.pascogov.com) <br />