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" �813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Pertnit <br /> �._ �,-_r�•..,. . �.�.��,�,,�w,�::,�.�-��.,;���.���.:�,..... -..«�����.�,��.�->, <br /> Owner's Name "� �l� ��� O�y ( <br /> � � � ✓ �' er's Phone Number <br /> Owner's Address ,��'' S ✓��Q <br /> Fee Simple Titleholder Name Titleholder Phone Number �� C� C� <br /> Fee Simple Titleholder Address <br /> f�-= , - r.: =�ac s�i.�h.�a.s. r�4�:"s��°- _, :.�� i- +�:.:�_�.,,.x-;,,,�:cm�» <br /> `"� , o� � S�-reQ/�- �� <br /> Job Address — <br /> Lot# <br /> Sub Division Parcel# <br />. • .,.<�.. <„e ry-�., <br /> p.a,:a�.9.�5,,'!r;<�„ro.^t:<Mu`�l`.,:�+4[H��K�&:.s,;v-a�i:,r-- ..�, . a�l- ' .«w� . —an vn <br /> a._. .. .-.. ..d�... :�".1!'��t:^.+s h.�^un�.:5-�.wa^a..,:a<�.. . q ,..g..; . :1:kSi�m,w�e;ryrj,�•4.�'r,. <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)„pdQhIUAL <br /> � Controlled Bum � Hood Installation r''� <br /> � Emergency Generator<30 kw a LP/Natural Gas-Installation �,1� • <br /> a Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale � �� � .-�`` <br /> aFire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> �� emi � er <br /> Sprinkler ❑ ❑ ❑ � � Recreational Bum V (� <br /> Fire Alarm �` O ❑ �C� � Sparklers �� ��� <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations Gi' , <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle �� <br /> � Fire Pumps � Waste Tire Storage ANNUAL � i/��� <br /> � Fire Works `y <br /> � Flammable Application-ANNUAL Valuation of.PrOl�@Ct <br /> � Fuel Tanks ' (� <br /> Q Other: , -� <br /> P• � <br /> Y ¢%?",Ar» ,_t., r ..tz°�m'-.."d":=hk�'�'�:.A"�7..e,`^��-�°i�'3:b:�.dF�k`.'S1'b�°'�"i6:'a2L#�'.#5:: :,_. .'%R.."'�..�F��6��,� . . � <br /> Contractor Company <br /> Signature Registered Y/N Fee Curr = Y/N <br /> Address <br /> License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER <br /> Company <br /> 5ignature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> UECHANICAL <br /> Company <br /> 3ignature Registered Y/N Fee CuRent Y/N <br /> Address <br /> License# <br />�THER <br /> Company <br /> iignature Registered Y/N Fee CuRent 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(http://appraiser.pascogov.com) <br />