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s�aaao-oo2� City of Zephyrhills Fire Fax-813-780-OD21
<br /> � , . ,Permit Application
<br /> Date Received Phone Contact for Permit �„���,�
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<br /> Owner's Name ��� � {'7� 'r� ;� Owner's Phone Number �). � �o�
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<br /> Ovmers Addres� /'1 �`
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address
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<br /> Job Address Lot# �
<br /> Sub Division PaFcel# ' '
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<br /> Ili � �. Bio-Hazard Waste Storage-ANNUAL ,� a Fumigation Tent�
<br />� � Comm Exhaust Kitchen Hood/Duct � fHaiardous Material(Tier II or RQ Faci'y}ANNIfk
<br />�� � Controlled Bum ' � Hood Instaliation
<br />' � � Emergency Generator<30 kw � CPlNatural Gas-Installatio =�
<br /> 0 Emergency Generator>30 kw � � LP/Natural Gas-ANNU Sale ��
<br />' � Fire Protection Maintenance-ANPIUAL Places of Assembly-A UAL
<br /> t y emi � �er,;- ,
<br /> Sprinkler �' �❑ ❑ ❑;' t-�" �Recreational Bum
<br /> Fire Alartn � ❑ ❑ ❑�?�� � Sparklers
<br />� Hood Cleaning � ❑ ❑ ❑ � � Sprinkler Sy§tem installation � �(„
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<br /> Hood Suppression �❑ ❑ ❑ O � � Standpipes(Spririkler Sys) � i �
<br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle �
<br /> � Fire Pum s `' � Vilaste Tre Storage`'ANMUAL
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<br />�, � Fire Works
<br /> � FlammableApplication-ANtdUAL VelUBtlOf1 Of PfOJ@Ct
<br /> Fuel Tanks
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<br /> Contract�o�� ' _ � . � Company - � - �
<br /> Signatufe�l' Registered Y/N Fee:Cu��ent Y/'N
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<br /> Address � " License# - � ` � -
<br /> ELECTRICIAN Company _ -
<br /> Signature Registered Y'/N Fee Gurrent ' '- Y/`N
<br /> Address ' License# '
<br /> PLUMBER • � ' Company . • .
<br /> Signature ' Registe�ed 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 Current Y/N
<br /> Address License# �
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<br /> Directions: .~�- '. .
<br /> Fill out application 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)
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