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8�3-78�o2o City of Zephyrhills�Fir:e� Fax-8i3-�8o-o02� <br /> Permit Application <br /> late Received � Phone Contaet for Permit ,��� <br /> ::'3.'.5s%L-`=7,r�::x.'C+'sYdt'31��„ - -v_:�_.�. - ',�' . r �wrxr.+s,e�- . .. , . .—_.,___.,- <br /> hvners Name J 1'1 Ovmer's Phone Number � C� �,� <br /> )wners Address �Q ?J �{ � �['� �.�n � e Z � � s ' 3�� � <br /> =ee Simpls TiUeholde� Name TiHeholder Phone Number C� � � <br /> =ee Simple Titleholder Address <br /> .+��.,- •---°.:��,:--- �7 "�'°sh�,'��€�RI�'a��'!,�-'!:�°f46�a°'� <br /> Job Address c� C <br /> Lot# <br /> Sub Divisian Parcel# <br /> "r"��` . . �:7�8,it�=5�s1°e=.��;;.'s!i:,s;�z�r.���-�w�4�=ti.& <br /> aBfo-Hazard Waste Storage-ANNUAL � Fumigatlon Tent <br /> � Comm Exhaust FGtchen HoodlDuct � Hazardous Material(Tler li or RQ Facility)ANNUAI. <br /> � Controlled Bum � Hood Installatlon <br /> � Emergenoy Generator<30 kw � LP1Natural Gas-Installation <br /> Emergency Generetor>30 kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Mairttenance-ANNUAL a Places of Assembly-ANNUAL , J � � <br /> r y emi ATn ar 7 �G..� 3 <br /> 5prinkler � ❑ ❑ O � � Recreational Bum � � <br /> � �� ❑ �! I <br /> Fre Alartn ❑ ❑ Sparklers <br /> Hood Cleaning O ❑ ❑ � a Sprinkler System Installations <br /> Hood Suppression � O ❑ O C� a Standpipes(SprinWer 5ys) <br /> � Fira Alarm Installation � Torch.RoofinglTar KetUe <br /> Fire Pumps � Waste Tire 5torage ANNUAL <br /> Fire Works � <br /> Flammable Appllcation-ANNUAL Vafuation of Project <br /> Fus{Tanks <br /> � Other: <br /> ;��.���,.�.,. - <br /> . ,.�x�.��.� <br /> Contraotor . <br /> Signature - _ ComPa�Y � ' ��• .C. ` 'jt"�' _ � �ts, <br /> RegisterecJ Y N Fee Current N <br /> Address � �c � � �� ('� License# '+ <br /> J�. +J <br /> ELECTRICIAN Company <br /> 5lgnature Registered Y/N � Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER Company <br /> Signature Reglstered �Y/N Fee Curte�t Y/N <br /> Address <br /> Licensa# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER Company <br /> Signature Registerod Y 1 N Fee Current �'/N <br /> Address Lioense# <br /> T�e' •a- <br /> � , •- _��..r.�r�ac-=........._�:W.w-.e�v,...,.,�.,.._....._.. ._�.. _ x.,.e.a...:�.+:�1Hrs"��rsA�e- <br /> Directions: ° - , � st,,n.��-._ _. =Az_ . .. ,.... . ____at�^r.�e� <br /> .�....._......_... .._ ..._. ..k�,�—.-,r_ti T <br /> Fill out applicaUon oompletely. <br /> Owner&Contractor sign back of applicatior�,notartzed(Or,capy of signed contract with owner) <br /> �f over$2500,a Notice of Commencemant is required(Machanical work over�5000) <br /> Supply two(2)sets of drawings with appiicable dacumentation � <br /> Allow 10-14 days for revisw after suhmittal date. Parcel#-obtained from Prope�ty Tax Notice(http:/lappraiser.pascogov.com) <br />