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813 - 780 -0020 City of Zephyrhills Fire Fax- 813-780 -002 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> Owners Name Owner's Phone Number <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> Bio- Hazard Waste Storage - ANNUAL Fu <br /> g � � Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum I I Hood Installation <br /> n Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL <br /> 1Utrly1 (Semi UZI Uther <br /> Sprinkler n ❑ ❑ ❑ 1 Recreational Burn <br /> Fire Alarm ❑ ❑ ❑ 1 Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I ( Sprinkler System Installations <br /> Hood Suppression 1 ❑ ❑ ❑ Standpipes (Sprinkler Sys) <br /> I I Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> n Fire Pumps Waste Tire Storage ANNUAL <br /> Fire Works <br /> n Flammable Application- ANNUAL ` I Valuation of Project <br /> I I Fuel Tanks <br /> I I Other: I <br /> 3e'g'aV traMay. -zs8 .lriz �2 M .,.,zz.... 46P4. <br /> Contractor Company <br /> Signature Registered Y / N Fee Current I Y / N <br /> Address I I License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N Fee Current I Y / N <br /> Address I 1 License # <br /> PLUMBER Company <br /> Signature Registered Y / N Fee Current I Y / N <br /> Address 1 I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current I Y / N <br /> Address I License # I <br /> OTHER Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I License # I <br /> •�-- _."Sm .R'Y&3.s.'�"a,a.Y r m. =.w zc.....x.warssz..sm,wA.x::.R:Fak e.w...,.., <u .._..a:..,a ...,.s.��., Fw _.... z.: ......wui.:zwu .... _+4*i..aE :'.::...... ... a.. _�:__.... _ <. __... . . <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 />