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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> • Permit Application <br /> Date Received �— Phone Contact for Permif ��� �� <br /> Owner's ame`y-~ _ 'tS P t n IS t i Y r fi Owner s Phone Number <br /> OwnePsAd'dress u�-��^-1�'-'�-{iJ�th C � r' I 3 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address Lot# <br /> Sub Division Parcel# <br /> Bio-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Burn Hood Installation l� <br /> QEmergency Generator<30 kw LP/Natural Gas-installation <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> 0 Fire Protection Maintenance-ANNUAL Places of Assembly ANNUAL �7 <br /> ❑ try emi � ter <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ Sparklers <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ Standpipes(Sprinkler Sys) ��tt <br /> Fire Alarm Installation Torch RoofinglTar Kettle" <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Flammable Application-ANNUAL —� Valuation of Project <br /> ❑ Fuel Tanks <br /> Q Other: Ry­ <br /> _ <br /> Contractor �- �., comp' <br /> Sig ature yr. 'A4 Registered Y%`N`�—Fe Curreni— `"'"Y1-N— <br /> Addre License-# <br /> ELECTRICIAN Company <br /> Signature Registered YIN I Fee Current Y I 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 I N <br /> Address License# <br /> OTHER Company r <br /> Signature" I <br /> Registered Y/N Fee Current <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(htip://appraiser.pascogov.com) <br />