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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application 7 I -, - <br /> Date Received �— Phone Contact for Permit / I F I� <br /> Owner's Name ZC1d j=/ f Owner's Phone Number <br /> Owner's Address t- , 0 i C(A <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address Q -7 ,T---- Lot# <br /> Sub Division F Parcel# <br /> Bio-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct Q Hazardous Material(Ter II or RQ Facility)ANNUAL <br /> Controlled Bum Q Hood Installation <br /> 0 Emergency Generator<30 kw LP/Natural Gas-Installation <br /> 0 Emergency Generator>30 kw Q I.PINatural Gas-ANNUAL Sate <br /> Fire Protection Maintenance-ANNUAL Q Places of Assembly-ANNUAL <br /> Pffl_Y1 WWI. ® er <br /> Sprinkler ❑ ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ Sparklers <br /> Hood Cleaning ❑ ❑ ❑ = Sprinkler System installations <br /> Hood Suppression ❑ ❑ ❑ I� Standpipes(Sprinkler Sys) <br /> Fire Alarm installation Torch Rootingrrar Kettle <br /> PumpsF-1 Fire <br /> ire Storage ANNUAL - <br /> Flammable Application-ANNUAL <br /> fr Waste T 1� <br /> 1 Valuation of Project <br /> QFuel Tanks <br /> Other: _Y f <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y I N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N 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 I Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered 1 N Fee Current Y/N <br /> Address -� .hi ttl`t�.VtFw Z i',r vU-tt,,PjJ +tr 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://approlser.pascogov.com) <br />