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813-780-Q020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Receive d t Phone Contact for Permit � L-t�J � r� <br /> wner's Name- C. Owners Phone Number � �� � , <br /> J <br /> wner's Address , �`� r S , L <br /> �e Simple Titleholder Name Titleholder Phone Number � C� � , <br /> �e Simple Titleholder Address <br /> �b Address � S � �'-�-G� �1 ` S 'J 9 <br /> v Lot#� � <br /> �b Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen Hood/Duct � Hood Installation <br /> � Controlled Bum � LP/Natural Gas-Installation <br /> � Emergenc,y Generator<30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Emergency Generator>30 kw a Places ofAssembly-ANNUAL , �� <br /> �j Fire Protection Mainienance-ANNUAL � Rei;reationai[3um <br /> i�� �_y] emi � er --� � <br /> `�Lt r , r Sprinkler �- � � � B � Spariclers , <br /> Ir.n/t ylr�1 <br /> ���•���� Fire Alarm -- -�� � p �,_ .g._ _ Sprinkler System Instailations /� )��J � � 'I <br /> � 1�, 2 Hood Cle ng ❑ � ❑ / 9�'7 � l/ <br /> �r�vl �Standpipes(Sprinkler Sys) i 1 ! <br /> � � / <br /> � ��� Hood Sup ession "--O ❑` Torch Roofing/Tar Kettle <br /> Fire Alarm Installation C( yor(` � ��1.J c a Waste Tire Storage ANNUAL � <br /> ❑ "—• � T ► L� <br /> Fire Pumps <br /> � Fire Works <br /> � Flammable Application-ANNUAL � Valuation of Project <br /> � Fuel Tanks <br /> � � Other: <br /> �ntractor 1 . 1^���� ,1� t� ��� Company <br /> gnature VV[.t, U <br /> Registered Y/N Fee Current Y/N <br /> Address ✓ —� Lice�se# <br /> _ECTRICIAN �T' I �ij � ` . Company <br /> gnature J t �. <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> _UMBER <br /> gnature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> l�cense tk <br /> ECHANICAL <br /> gnature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> THER <br /> gnature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> irections: <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 two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice htt //a <br /> ( p: ppraiser.pascogov.com) <br /> vigil Inc <br /> Hood&Exhaust Cleanmg Svc � � '� <br /> �o BoX 2�3�a� m� <br /> Tampa,FI 33688 � �f��r-�O S <br /> P�813-932-9100 F 813-933-8988 �I�-� �- <br />