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813-780-0020 City of Zephyrhills Fire I-ax-61 3-mU-uuz1 <br /> Permit Application <br /> Date Received — Phone Contact for Permit pFM71 I M I <br /> Owner's Name Owner's Phone Number <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address Grc C6d Lot# <br /> Sub Division Parcel# <br /> ZZZ <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 q <br /> 0 Emergency Generator<30 kw LP/Natural Gas-Installation <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> F7 Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> r y emi ® ter <br /> Sprinkler � ❑ ❑ ❑ F-1 Recreational Bum / <br /> Fire Alarm ❑ ❑ ❑ = El Sparklers 1 C�t f ,, <br /> Hood Cleaning ❑ ❑ El Sprinkler System Installations ` (a�,�`l; Jo,r <br /> Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) �•Y,�Uy��;_C Yt� <br /> Fire Alarm Installation Torch Roofing/Tar Kettle V' <br /> f <br /> Fire Pumps Waste Tire Storage,ANNUAL __---. <br /> Flammable Application-ANNUAL i� -` Val-nation of Project= <br /> Fuel Tanks <br /> i Q Other: <br /> Contractor Company <br /> Signature Qy Registered /N Fee Current Y/N <br /> Address P (G S <A q L 3 License# L (( <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> a <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> i <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 /> i <br /> Address License# <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.pascbgov.com) <br />