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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 OSS,�Ozl u°N' G S !1 1JY G Owner's Phone Number . <br /> Owner's Address eNime <br /> zd.: !' ? J fir" f� ��� 7/ <br /> Fee Simple Titleholde .Titleholder Phone Number <br /> Fee Simple Titieholder Address <br /> Job Address Lot# <br /> Sub Division - Parcel.# <br /> . <br /> BiaHazard tlllaste Storage ANNUAL Fumigation Tent. <br /> Comm Exhaust Kitchen Hood/Duct ED <br /> .Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Bum Hood Installation <br /> a Emergency Generator<30 kw LR/Naturet Gas-10stallatior <br /> Emergency Generetor>30 kw LP/Natural Ga"NNUAL Sale <br /> Fire Protection Maintenance-ANNUALLjjj Places of Assembly-ANNUALILI <br /> We-ml® er . <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑, ❑ Sparklers 5 <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations J ` <br /> Hood Suppression ❑ ❑ ❑ R Standpipes(Sprinkler Sys) <br /> MFire Alarm Installation Torch Roofing/Tar Kettle <br /> Fire Pumps Waste Tire Storage.ANNUAL <br /> 8 Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> . Other: <br /> Contract Company <br /> SiPI)Ii5"4 &A-Mg� Registered E / , Fee Current 1. ,YFN <br /> Is License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/-N Fee Current I WN. <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N I Fee Current I /N 1. <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company71 <br /> Signature F 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 />