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8 1 3-7 80.002D City of.Zephyrhills�Fir.e FaX-ai�-�ao-ooz� <br /> ` Permit Application <br /> late Received � �0/\ ' Phone Contact for Pertnit 3 [=—L=�-1 �3� <br /> a�a:��::�.,:�wr_�_r��,.::........�..,.,...�.w_,.:.....n.-,...- ....�._-�ans2� - �s�, . .� .�. _ ---. -._._s,d,tv. . <br /> )wner's Name L���L Q �fO�Z y�Tf-1 Owners Phone Number �l � ST'� . �3�! <br /> )wners Address � Q, � /��O T�/%/77 � �J v / <br /> ee Simple Titleholder Name Titieholder Phone Number � � � <br /> ee Simple Titleholder Address e� <br /> �x -t,�"�.� �. - ���>. <br /> �' �ob Address ' �����, ��� <br /> �ub Division Parcel# <br /> aBio-Hazard Waste Storege-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material�er II or R(1 Facility)ANNUAL <br /> aControlled Bum � Hood Installation <br /> � Emergency Generator<30 kw a LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Naturai Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> r y emi �n er <br /> 5prinkler � O ❑ ❑ � Recreational Bum <br /> Fire Alarm � O ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ � ❑ � a Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � a Standpipes(Sp�nkler Sys) <br /> � Fire Alatm Installation � Torch Roofingffar Kettle <br /> a Fire Pumps a Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL —� Valuation of Project <br /> � Fuel Tanks <br /> a Other: <br /> :.ontractor Compa�y /�// �Q.S� �� <br /> 5ignature � Registered l�/N Fee Current Y!N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered �'/N Fee Current �'/nl <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 Curtent Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Add2ss License# <br /> Directions: <br /> Fill out application complstely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed con[ract 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. Parcel#-obtained from Property Tax Notice(httpJ/appraiser.pascogov.com) <br />