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a�3-7ao-oa2o City of Zephyrhills Fire Fax-s�3aso-ooz�
<br /> Permit Application
<br /> Date Recei'ved � � —� Phons Contact for Perrrtit � C�M��
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<br /> Owner's Name \ Y Owne�'s Phone Number �� [� C� '�
<br /> Owners Address �1 �
<br /> Fee Simple Titleholder Name Titleholder Phone Number [� � �
<br /> Fee Simple Tit(eholder Address '
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<br /> .lob Address lof# ��
<br /> Sub Division Parcel#
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<br /> � Biq-Hazard Waste Storage-ANNUAL � Fumigation Tent
<br /> � Comm Fxhaust K�tchen HoodlDuc# � Hazardous Material(Tier II or Rt2 Facilify}ANNUAl.
<br /> � Controlled Bum � Hood Installation
<br />' � Emerge�cy Generatar<3d kw Q LPINatural Gas-Instaita#ion
<br /> � Emergency Generator>30 kw � LP a�-
<br /> � �`�
<br /> Fire Protectian Maintenance-AHNUAL 'Iaces of Assemb(y-ANEt�lAL
<br /> ❑�y emi �n t er �
<br /> Sprinkler ❑ ❑ ❑ Recreatianal
<br /> Fire Alarm � ❑ O ❑ � � Sparklers �� ��
<br /> Nood Cleaning � ❑ � ❑ �� � Sprinkler System Installations j
<br /> Hood Su ression ❑ ❑ ❑ Standpipes(Sprinkler Sys) �
<br /> PP ❑ � � ,
<br /> � Fire Alarm Installation � Torch ftaofinglTar Kettle ��}�`
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � F(ammabie Application-ANFtUAL � ������� � Valuation of Project
<br /> � Fuel Tanks
<br /> [� Uther:
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<br /> Cantractor Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address �fcense#
<br /> ELECTRICIAN Company
<br /> Signature Registered Y 1 N Fee Current Y/1�
<br /> Address License#
<br /> P�Utv3BER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address �icense#
<br /> MECHANICAL Company
<br /> , Signature Registered Y/N Fee Current Y/N
<br /> �i Address License#
<br /> Q7HER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
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<br /> Directions:
<br /> � FiI!out app(ication completely.
<br /> Owner&Cantractor sign back of application,notarized(Or,copy of signed contract with owner)
<br /> (f over$25Q0,a fVotice of Commencement is required(Mecha�icai work over$50Q0}
<br /> Suppiy iwo(2}sets of drawings with applicable documentation
<br /> Allaw 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
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