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813-780-0020 City of Zephyrhills Fire Fay- 80-0021 <br /> Permit Application <br /> Date Receive Phone Contact for Pe t <br /> Owners Name eO'CN Owner's Phone Number <br /> Owners Address 'FL- 33 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address Q)rNLL %W .�.:f ,r" ..Lot# <br /> Sub Division Parcel:# ?.Ti' 01�2.�0;.=,Z;:��W 0 'moo <br /> a� t` <br /> Bio-Hazard Waste Storage-ANNUAL Fumigation;Tent•_.:•Y.F <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 Asserr` ly-ANNUAL - <br /> ®y r 9emi ®n er <br /> Sprinkler. - - E ❑ ❑ ❑ Recreational Bum__ <br /> Fire Alarm ❑ ❑ ❑ Sparklers <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation Torch Roofing/Tar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Flammable Application-ANNUAL 2—y40.QZ) I Valuation of Project <br /> 0 Fuel Tanks <br /> 0 Other: <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> OTHER Company <br /> Signature ?�acV�� �'t��aQO Registered Y N I Fee Current Y/N <br /> Address %_% 2aT` �' Q(aO T—L %V)l License# J C.SC\ <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 />