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813-�^�-002o City of.Zephyrhills Fir:e FaX-s�aaao-oo2� <br /> ' Permit Application <br /> �.- p <br /> )ate Received T�� �' 17f�2 Phone Contact for Pertnit t��3 ,7�}.,� / 3 S� <br /> „-. �,... .�n �----�_�,�w,�� �� - - <br /> s;sa t;r-_.:��..::�,�'�u;ts�..,..........:�.....,�..v_..�.�._,�.-..,..�.....,�� <br /> .- . _�_..L,..._:..�,, ^� <br /> )wner's Name ' S��� ������ Owner's Phone Number g13 �'�S . 935� <br /> )wner's Address � �^ ��� ����� �� ���" � <br /> ee Simple Titleholder Name Titleholder Phone Number � � � <br /> ee Simple 7itleholder Address <br /> ,�r m.--s,.:����sr��x����:. <br /> aa" .'�"-m���"""' ' -- � b <br /> NP���5 � ��LS 38/�t5 �.�Tft. ,,�V'� �o�� 0 <br /> ob Address _ <br /> �ub Division Parcel# <br /> � Bio-Hazard Waste Storege-ANNUAL � Fumigation Tent <br /> � Comm F�chaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generetor>30 kw a LP/Natu21 Gas-ANNUAL Sale <br /> a Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL <br /> �y emi �n er � �/`� � � <br /> 5prinkler � ❑ ❑ ❑ � a Recreational Bum � �� <br /> p ❑ ❑ Sparklers � <br /> Fire Alarm � � � <br /> Hood Cleaning � ❑ ❑ j� � � Sprinkler System Installalions <br /> Hood Suppression � ❑ ❑ O � � Standpipes(Sprinkler Sys) <br /> aFire Alartn Installation � Torch RoofinglTar Kettle <br /> a Fire Pumps a Waste Tire Storage ANNUAL <br /> aFire Works <br /> � Flammable Application-ANNUAL �---� Valuation of Project <br /> � Fuel Tanks <br /> � Other: <br /> � <br /> �ontractor Company �� � � <br /> 5ignature �� Registered Y/N Fee Current Y/N <br /> Address 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 License# <br /> MECHANICAL Company <br /> Signature Registered Y/(�1 Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# ���� <br /> . �. � <br /> Directions: <br /> FII out application completely <br /> Owner&Contractor sign back of applicaUon,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required_(Mechanical worlc 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(httpJlappraiser.pascogov.com) <br />