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. II13-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received �� Phone Contact for Permit C5� 7 3 2 5 3 2 6 <br /> Owner's Name �r't'};FI F lcri�a inc c o r�,�r�in r Foez h �..omp3��; Owner's Phone Number C� � � <br /> PO Hor 802206 <br /> Owner'sAddress ll�lla;. 't'x 75��o-??nh <br /> Fee Simple Titleholder Name Titleholder Phone Number C� � � <br /> Fee Simple Titlehoider Address <br /> JobAddress �E'�-j Gall t:��ule�iard, zeptryr�hill:;, f'I� 33Sa1 �I321 � Lot# � <br /> SubDivision zephyrhi_lls S��ipeL Cenr,ci A Parcel# 3] 25 zl olln )onon u0.10 <br /> � Bio-Hazard Waste Slorage-ANNUAL � Fumigation Tenl <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood InstallaUon <br /> � Emergency Generator<30 kw � LPlNatural Gas-Installation , <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL,SaIe � <br /> oFire Protection Maintenance-ANNUAL � Places of Assembly-AN�UAL /� �� <br /> try emi �n t er �� <br /> Spnnkler � ❑ ❑ ❑ � � Recreational Burn � � �'` <br /> Fire Alarm � I I I_I LJ � � Sparklers ,` � <br /> _..�'",,.� <br /> Hood Cleaning � ❑ ❑ ❑ � � Spnnkler System Installatians <br /> Hood Suppression � [] � f I � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettie <br /> aFire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> ❑ Flammable ApphcaUon-ANNUAL � Valuation of Project <br /> � Fuel Tanks <br /> � Other <br /> Contractor Company �� � � � � <br /> Signature Registered Y/N Fee�urrent Y/N <br /> Address 953 NI? Osceo7a Avenue, ucala, P'1� 34�170 License# n6-96150002198:� <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee��urrent 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 Company <br /> Signature Registered Y/N Fee Currenl Y/N <br /> Address License# —� <br /> D�rections <br /> Fill out application completely <br /> Owner 8 Contractor sign back of appl�cation,notarized(Or,copy of signed contract w�th owner) <br /> If over$2500,a Nohce of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings wilh applicable documentation <br /> Allow 10-14 days for review after submittal dale Parcel#-obtained From Properry Tax Nolice(http//appraiser pascogov com) <br />