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s�saao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Reeeived ` Phone Contact for Permit �__�__� <br /> �._m-..__________.:_r__..__.�...�_._______._�_.�_..:_.,._.��_:_...,..�.._..,_.��-.......__,..__�._-...,....-�,..�u_..._-_.—_..<._� _ ___.___.�._._---___e_�.�_v_______.____ <br /> Owner's Name ��. cS p �►'Y�e r�ect �� �� A�e,m Owner's Phone Number � � � <br /> Owner's Address �Jq�11 ��� O-d� �d�. <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> _�.,_.��.H....-�..__...�, -- - - ,��.w-=:—.._--�°°-._.,�. ��..� �-�.'°i <br /> Job Address Lot# '� <br /> Sub Division Parcel# <br /> c..�_1�.��.,w�..M__x�._....,.. .....-._.a._._r.,�.,.�.-_,.__..�..._v...-...�n._._..�.,.,....._..�,__..,�._._,._-.�a�=_.�_.._m.�__.___�..�._..___°_�._. .T-r..,____.-________-_-..�.... _..__._�__..—, <br /> � Bio-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 /> t y emi �n t er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Burn r �� � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers � �I� <br /> Hood Cleaning � � ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm 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 /> Q ther: <br /> .��..�.._..�____.._— _ — -.e._v�.ew��...-.....w._.-:.,.�.L.._�-,..�-_�-.._.-..�_......�....�....�.......«.n-a,..�.�__f�....�a�,e.e.�.�.�.`�,s.a-.�...._e.-.e-,..-�...-r..,,...�.�_�..e._=�.�,....,.�..�:�.�.�...e..>'._-.'�;�3 <br /> Contractor � Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Curzent 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 Company <br /> Signature Registered Y/N Fee Curcent Y/N <br /> Address License# <br /> ° - �.__�,. ...�_�_._...�.�.�__—.---___,.,.�_.._�___�_n_._...__.. _.._����_ __._�..__-a-°_~-___."_,.�___,.._���...._._.___�..�____�_._._��_�Y--°---�- -� <br /> �Directions: , <br /> Fill out application completely. <br /> Owner 8 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 PropeRy Tax Notice(http://appraiser.pascogov.com) <br />