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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 C--7 E <br /> Owner's Name r5 Owner's Phone Number © <br /> Owner's Address 10s` o tS Qk I 3--Ar.14—L <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> z <br /> Job Address Lot# <br /> Sub Division Parcel# <br /> Q 'Bio-Hazard Waste Storage-ANNUAL o Fumigation Tent 3 <br /> Q Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> 11 Controlled Bum o Hood Installation <br /> Emergency Generator<30 kw 0 LP/Natural Gas-Installatior <br /> 0 Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sate <br /> ® Fire Protection Maintenance-ANNUAL ® Places of Assembly-ANNUAL <br /> tri-yl rrem—il An Other <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ 1� Sparklers <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> QFire Alarm Installation Torch Roofing/Tar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> RFlammable Application-ANNUAL 1�r Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor Company <br /> Signature Registered Y/N Fee Current <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 Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current <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$50001, <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 />