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O 1a-I0u_uuZu <br />Date Received <br />Owner's fume Q <br />Owner's Address 3 60 Swt6 G5, <br />Fee Simple Titleholder Name C <br />Fee Simple Titleholder Address <br />Job Address <br />Sub Division , <— <br />Bio-Hazar st orage - <br />Controlled Bum <br />Emergency Generator < 30 kw <br />aEmergency <br />Generator > 30 kw <br />aFire <br />Protection Maintenance - ANNUAL <br />try <br />rg—effi`il ®n <br />ter <br />Sprinkler ❑ <br />❑ <br />❑ ❑ <br />Fire Alarm ❑ <br />❑ ❑ <br />Hood Cleaning ❑ <br />❑ ❑ <br />Hood Suppression <br />❑ <br />❑ ❑ <br />City of Zephyrhills Fire <br />Permit Application <br />Phone Contact for Permit <br />Owner's Phone Number <br />WUi�e <br />Fax-813-780-0021 <br />3 <br />Titleholder Phone Number <br />Comm Exhaust Kitchen Hood/Duct Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas -Installation <br />LP/Natural Gas -ANNUAL Sale <br />Places of Assembly -ANNUAL <br />Recreational Burn <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Fire Alarm Installation F7 <br />Torch Roofing/Tar Kettle <br />-51 <br />F7 <br />Fire Pumps F7 <br />Waste Tire Storage ANNUAL <br />Flammable Application- ANNUAL <br />2 S700, Oc'J <br />Valuation <br />of Project <br />Fuel Tanks <br />0 <br />Other: <br />Contractor( <br />Company <br />r <br />G� M <br />Signature <br />' <br />" t V� l <br />Registered <br />/ N <br />Fee Current <br />Y / N <br />Address <br />License # <br />ELECTRICIAN <br />Company <br />Signature <br />Registered <br />I Y / N <br />Fee Current <br />Y / N <br />Address <br />License # <br />PLUMBER <br />F <br />Company <br />Signature <br />Registered <br />Y / N <br />Fee Current <br />Y / N <br />Address <br />License # <br />MECHANICAL <br />Company <br />Signature <br />Registered <br />Y / N <br />Fee Current <br />Y / N <br />Address <br />License # <br />OTHER <br />Company <br />Signature <br />Registered <br />Y / N <br />Fee Current <br />Y / N <br />Address <br />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 />