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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date'Received� -_ Phone Contact for Permit­ <br /> J' Owner s Phone Number <br /> Owner's Name 7G — 'j t r A nGt� SSOGi 4 Jd <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number L� <br /> Fee Simple Titleholder Address <br /> Job Address <br /> Sub Division Parcel# <br /> r_._a-_- __= - <br /> QBio-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> Q Comm Exhaust Kitchen Hood/Duct Q Hazardous Material(Tier 11 or RO Facility)ANNUAL. <br /> 0 Controlled Burn Hood Installation <br /> Emergency Generator<30 kw LP/Natural Gas-installation <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> Q Fire Protection Maintenance-ANNUAL r---O P-laces of As 7 mbly-ANNUAL <br /> U y emi t er <br /> Sprinkler ❑ ❑ ❑ F-1 Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ = Sparklers <br /> Hood Cleaning ❑ ❑ ❑ = Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> QFire Alarm installation Torch Roofing/Tar Kettle <br /> Fire Pumps a Waste Tire Storage ANNUAL <br /> Flammable Application-ANNUAL —� Valuation of Project <br /> ❑ <br /> oFuel Tanks <br /> 0 Other: _- <br /> r__ <br /> Contractor- , Company <br /> -9 I �/ Registered Y/N Fee Current Y/N <br /> Signature YPS! <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered I Y/N Fee Current LY/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 <br /> Signature Registered Y/N Fee Current Y/N <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.pascogov.com) <br />