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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> C Permit Application <br /> Date Received _ 'Zis Phone Contact for Permit <br /> _ --- <br /> Owner's Name Cl f/ d�Y/� GL� Owner's Phone Number <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address �/ / r' �` ��G d /��� / �S^ Lot# <br /> Sub Division Parcel# <br /> F7 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 <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 /> r y emi ®n ter <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ �Srsparkle / <br /> Hood Cleaning � ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ Standpipes pnn er Sys) <br /> Fire Alarm Installation Torch Roofing/Tar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL b C <br /> Flammable Application-ANNUAL 277 Valuation of Project <br /> Fuel Tanks <br /> Q Other: �/L 1 GGE� / n+ i 1" <br /> Contractor `� Company -4-d e . ..� <br /> Signature ` Registered . Y/N Fee Current I Y/N <br /> Address L S .fj - i✓ a- f✓r/�/ J a I f License# P (0,6'a � <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current 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 <br /> Address License# <br /> OTHER Company c <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> Directions: 9 <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 />