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e�s-�so-oo20 , City of Zephyrhills Fire Fax-813-780-0021 <br /> ' ` Permit Application <br /> Date Received Phone Contact for Permit � ��� q��U <br /> Owner's Name I i la.� .J�[J � � Owner's Phone Number �5�� Z�y 7i�� <br /> Owner's Address 1'� 1J�� ( I C 7� � ��I 1'� :J�J l��� <br /> Fee Simple Titteholder Name Titieholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> JobAddress J���5 L-►r�.11 (�i��,. h r`u,115 � �L� J��`I � Lot# � <br /> Sub Division Parcel# ��'�i(y 'Z�'�[.(1 -���� '[7�/�j� <br /> a Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LPINatural Gas-Installation � <br /> � Emergency Generator>30 kw a LP/Natural Gas-ANNUAL Sale " �?j <br /> Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � � <br /> r y emi �n er � <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleanmg � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � � ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other <br /> Contractor Company <br /> Signature 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/N Fee Curcent Y/N <br /> Address License# <br /> OTHER �.- �% /� Company 'y� � � <br /> Signature � Registered N Fee Current Y N <br /> Address �j v, ; ' License# Q[Z}[;(yC�� <br /> Directions: <br /> Fill out application completely <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> N 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 irom Property Tax Notice(http://appraiser.pascogov.com) <br />