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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> ° ' - Permit Application <br /> Date Received ^g �Z� Phone Contact for Pertnit $l °1 q�s (v 6�j <br /> Owners Name � �j'7�t-- Ovmers Phone Number s(3 7�o bc�oo <br /> Owner's Address /�—'/ 3 Z <br /> Fee Simple Titleholder Name �� � `�� Titleholder Phone Number C� � � <br /> Fee Simple Titleholder Address <br /> - . :;,r:��tr:ie * {'A't`42�'S�s^t '�'�53:r�;�z�,ai: ,�.�s+,� r,e s•� ,�= :��e^:..v.-j6r�'k'�� ��,�'+`«*.���5"w3:�".t�i"s.'�'J^:." � <br /> ��F., <br /> Job Address Lot# � <br /> Sub Division Parcel# <br /> ..;, .... ....w ,,.r.�r.?ka�o:�4?:2e.���..,�.&:.."k�..>.z�.Y?'�;i.�t-sr < . ... .., �. ,. . r,.> . . <br /> .. ,r.:�:-�,,,.u-„�< � . . �• :s°a�m�-�.:sr�.s'�;.a�a:.sr...:sss.., �;3 , <br /> � 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 /> aEmergency 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 /> �y emi �n er � <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Aiarm � ❑ ❑ O � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression �/ ❑ ❑ �� a Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Fiammable Application-ANNUAL Valuation of Project <br /> Fue�Tanks <br /> Q Other: <br /> �3 ' . .... . . .......f:,e'`�R�o. .,•te`�",� .�.`f' . ..,t " ." . - � . . a,.:�1:�'i�'a".ti.:f`r:'�h.l.::. ..^�d.:abi:». ..�.9�+'�w.:'�.. . , , « <br /> Contractor Company �/— /1� <br /> Signature Registered Y/N Fee Current Y/N <br /> Address O License# <br /> ELECTRICIAN Company <br /> Signature I Registered Y/N Fee Current Y/N <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 Current Y/N <br /> Address License# <br /> OTHER <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address M License# —� <br /> Directions: " , .. ..._..,. ,....,, ,. . . <br /> Fill out application completely <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply hvo(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 />