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o 1 o- i ou-uuzu <br />City of Zephyrhills Fire <br />Permit Application <br />Fax-813-780-0021 <br />Date Received <br />Owner's Name L 0Q <br />Owner's Address I J W <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br />Job Job Address <br />Sub Division <br />F] <br />F7 <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Burn <br />Emergency Generator < 30 kw <br />Emergency Generator > 30 kw <br />Fire Protection Maintenance - ANNUAL <br />ry <br />Sprinkler <br />❑ <br />Fire Alarm <br />❑ <br />Hood Cleaning <br />❑ <br />Hood Suppression <br />❑ <br />Phone Contact for Permit <br />Titleholder Phone Number <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas <br />-Installation <br />a <br />LP/Natural Gas -ANNUAL Sale l <br />Places of Assembly -ANNUAL <br />emi n ter <br />❑ ❑ <br />Ej <br />Recreational Burn <br />❑ ❑ <br />Sparklers 1 <br />❑ ❑ <br />Sprinkler System Installations <br />❑ ❑ <br />Standpipes (Sprinkler Sys) <br />Fire Alarm Installation <br />Torch Roofing/Tar Kettle <br />Fire Pumps <br />Waste Tire Storage ANNUAL <br />Flammable Application- ANNUAL <br />2 S700, QrO <br />I <br />Valuation of Project <br />Fuel Tanks <br />0 <br />Other: <br />Contractor <br />( <br />Company <br />r <br />It, e 4' <br />^M <br />Signature <br />V <br />Registered <br />/ N <br />Fee Current <br />Address <br />License # <br />ELECTRICIAN <br />Company <br />Signature <br />Registered <br />Y / N <br />Fee Current <br />Address <br />License # <br />PLUMBER <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 />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 />