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813-780-0020 City of Zephyrhills Fire Fax-813-790-0021 <br /> Permit Application <br /> �te Received « Phone Contact for Permit ( f> �i � 3 C <br /> r���,.��.��^��a , es � "�«°*�"_ <br /> � C �f (,v/�(;(M�}{t.f /NS��E� Owner's Phone Number � � � <br /> vner's Name �` � � <br /> vner's Address � �� �n CC f 7t"V',, �,��{ � � �l`, �C " � v <br /> �e Simple Titleholder Name Titleholder Phone Number �] C� r�� <br /> �e Simple Titleholder address <br /> I�.':'�.'k'�� . � <br /> �ob Address C� 3 f��•4 �L LV . c�C'/�ld �l�i�`1' %C 3 � S`1� �ot# <br /> �nb Division Parcel# <br /> i����� <br /> � 8io-Hazard Waste Storage-ANNIIAL � Fumigation 7errt <br /> � Comm Exhaust Kitchen Hood/Duci � Hazardous Materiai{Tier II or RQ Facifity)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Cias-Instal{ation <br /> � Emergency Genergtor>30 kw � LP/Natural Gas-ANNUAL Saie <br /> � Fire Protection Maintenance-ANNUAL Q Places of Assembly-ANh1UAL <br /> [� emi �Tn er � i ,('7 Q�i <br /> Sprinkler � ❑ ❑ � � � ReCreatton8l Bum �� ��`�J <br /> Fire Alarm � ❑ � ❑ � � Sparklers <br /> ood Cleanin� � O ❑ � � Sprinkler System Installations <br /> Hoa uppression ❑ ❑ ❑ �� � Standpipes(3prinkler Sys) <br /> � <br /> a Fire Alarm Instailation Q 7orch Raofing/T'ar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works ,�,�„„�,�„ <br /> � Flammable Appiication-ANNUAL �r � Valuation of Project <br /> aFuel Tanks <br /> Q Other• <br /> ��,.�.�� . ra� <br /> Coniractor - Company �J� %�� }�'�lK� GC� <br /> Signature C Registered N Fee Current Y <br /> Address . ,' ( d'� (.�C �G �-��� 3 S License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER �� Company <br /> Signature Registered Y/I�f 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 <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> ,...'�f .)..;.b�,�,,,, ;s,,.n..ur..: .n�:o;.;F.....;:..�. �,,..n .....�tt,w.a �� � �.. ..., ..� .., ,.. . , ' tr�� ,,, .,. ,:f�X;.�. ."�.',�:�.^,.�,.��� _ . . '.. 3�J' 'AU.s :rvY�,'�':h"v,•'>n;".i ��.,� � <br /> License <br /> . . . . .... , ,. ... , ., �„ <br /> Directions. <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract vv�th 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:/lappraiser.pascogov.com} <br />