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813-780-OC20 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> D3t8-F��G@ett�l Phone Contad for Pertnit 7 7 � d� <br /> Owner's Name n ei C,rl Ze �t �1 S Owners Phone Number � � � <br /> o�rs�adr� �a 5� Y-�- �Y1 � . � j� �=L 3 3 5 2— <br /> Fee Simpie Titleholder Name Titleholder Phone Number C� � � <br /> Fee Simple Titleholder Address <br /> Job Address Lot# � <br /> Sub Division Parcel# • <br /> a BiaHazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier il or RQ Facility)ANNUAL . <br /> � Controll�d Bum � Hood Installation <br /> � Emergency Generator<30 kw � LPMatural Gas-Installation <br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Saie <br /> � Fire Proteetion iviaintenance-ANNUAL � Pfaces of Assembly-AN�IUAL <br /> �y emi � er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ O ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ �f ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn 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 /> � Other: <br /> Contractor , Company �� Yt. �t. G <br /> Signature ��� ' Registered Y/N Fee Current Y/N <br /> Address L! � 1 t,t) t 3 5'L �icense# "0 Os � �� <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 /> ��.� <br /> Address License# <br /> MECHANICAL Company -1 <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature ' Registered Y/N Fee Current Y/N <br /> Address License# <br /> 2 <br /> �Directions: <br /> Fill out appliption completely. <br /> Owner&Contractor sign back of appliqtion,notarized(Or,copy of signed conVact 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. Parcet#-obtained from Property Tax Notice(http:/lappraiser.pascogov.com) , <br />