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813=780-0020 City of.Zephyrhills Fire Fax-813780-0021 <br /> �Permit Application <br /> Date Received �� Q6 �� /� Phone Contact for Permit �3 J�t/✓ 93.�i <br /> s:�-.�e����s ,��...�..w,..��. ,»eR......,.�... <br /> . �n.�.<«. .,_....... <br /> Owner's Name L � J� V r Owner's Phone Number 8 f� ��,'J�' �3�� <br /> Owner's Address ��, x —//� TTJMP/q �L 3 3 6 7 <br /> Fee Simple Titlehofder Name TiUeholder Phone Number � � C� <br /> Fee Simple 7itieholder Address <br /> '>�?is:.. <br /> JobAddress � L� QN W'I��LS �C,� ���{'����� � Lot# � <br /> SubDivision ��'ilyS ��, � Paroel# <br /> �.�:. <br /> .�; . <br /> � 6io-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> � emi � er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning �❑ ❑ � � � Sprinkler System Instaltations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(SprinklerSys) <br /> � Fire Alarm Installation � Toroh Roofingffar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Appiication-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> ���;;�x <br /> Q Other: <br /> Contrector <br /> Company � <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature I 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 Current Y/N <br /> Address License# <br /> OTHER <br /> Company <br /> Signature Registered Y/N Fee Current Y 1 N <br /> Address License# <br /> Directions: <br /> Fill out appiication completely <br /> Owner&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 />