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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received I // Phone Contact for Permit <br /> Owners Name �6 A1, All(E ✓/Cl 0 2 � /h e� S Owner's Phone Number E= C� <br /> Owner's Address t 5 �'UiL t ( K 'Zc A*-t t J I�L 3 3 5 q Z- <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address Lot# L <br /> Sub Division Parcel# <br /> O � DBE <br /> o Bio-Hazard Waste Storage-ANNUAL o Fumigation Tent <br /> Q Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RO Facility)ANNUAL <br /> QControlled Bum o Hood Installation <br /> 0 Emergency Generator<30 kw a LP/Natural Gas-Installatior <br /> 0 Emergency Generator>30 kw, o LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> Qtrl emi ® Other <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ Sparklers <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation Torch Roofingrrar Kettle <br /> Q Fire Pumps a Waste Tire Storage ANNUAL <br /> R <br /> Flammable Application-ANNUAL 1 Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor Company <br /> Signature Registered Y/N Fee Current YY/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered I Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered I Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered I 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$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 />