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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 1 I 1 <br /> Owner's Name Owner's Phone Number . <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> .. °r. ,:: .. ., >,.. ;. ; i ash 414 .,, < x. i W stia . ;',, . q% _ .h.g ,_.. ' .. - . W, , �,e . Mit :,s .. , . .r. <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct I ( Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> FT Controlled Bum n Hood Installation <br /> FT Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> 1 Emergency Generator > 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> lUtrly1 1Semi1 I""' I Other <br /> Sprinkler 7 ❑ ❑ ❑ ( Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning I I ❑ ❑ ❑ I I Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I I I 1 Standpipes (Sprinkler Sys) <br /> 1 Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> R Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> ; Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> I___i Fuel Tanks <br /> n Other: I <br /> _.:Tni ON MA.,r. = IE_ _. ✓<..._..w::,.. k,. w.uiubkaMai .wi. w� .;.:« NTMAZ . .N.S:•,. MaMigi .Z .ue ..a',c _, M.:._ .S...R. , a.. r.,. sa _ .w',:: : ::W= rT1 -..,z ..a. .____..:.n-:; : ::t. L - :i <br /> Contractor Company <br /> Signature Registered Y / N j Fee Current 1 Y / N <br /> Address ( <br /> 1 License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N 1 Fee Current I Y / N <br /> Address 1 <br /> I License # <br /> PLUMBER Company <br /> Signature Registered Y / N J Fee Current I Y / N J <br /> Address I <br /> 1 License # <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I <br /> I License # <br /> OTHER Company J <br /> Signature Registered Y/ N 1 Fee Current 1 Y / N <br /> Address 1 <br /> 1 License # <br /> Directions: <br /> i <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 />