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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 /> Owner's Name V/ Owner's Phone Number <br /> Owner's Address 8 63,0 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address v ct 81_ Lot# <br /> Sub Division Parcel# <br /> 0 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 <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 /> t y emi I [A7n ter <br /> Sprinkler ❑ ❑ ❑ ❑ Recreational Burn El Fire Alarm ❑ ❑ ElSparklers p tv—feg?v <br /> Hood Cleaning 1:1 ❑ ❑ ❑ Sprinkler System Installations ��/ <br /> Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) (J�D <br /> Fire Alarm Installation Torch Roofing/Tar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Flammable Application-ANNUAL I 2 Valuation of Project <br /> Fuel Tanks <br /> 0 Other: <br /> Contractor Company /- YIL <br /> Registered Y/N Fee Current Y/N <br /> Signature -"�/' - - %-�'-- "'.-.`_-- - g' <br /> Address O _ - __-- =-_ = License# <br /> ELECTRICIAN '�- Company <br /> Signature Registered Y/N Fee Current <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 <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 />