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813 -780 -0020 City of Zephyrhills Fire Fax -813 -780 -0021 Permit Application Date Received — — / Phone Contact for Permit Owner's Name I a j y o j it yeio. 5 I Owner's Phone Number I H I I I Owner's Address I , 4'7' g70 e Fee Simple Titleholder Name I I Titleholder Phone Number I 1 I Fee Simple Titleholder Address I Job Address I Lot # I Sub Division I Parcel # I 1 $ ,a rI Bio-Hazard Waste Storage - ANNUAL Hazardous Material (Tier II or RQ Facility) ANNUAL . El Comm Exhaust Kitchen Hood /Duct = Hood Installation AM' / C) N$ Controlled Bum n LP /Natural Gas - Installation ° 9 0 Emergency Generator < 30 kw LP /Natural Gas-AN UALSaI p th i Emergency Generator> 30 kw -ANNUAL r grit' �r�`� ` Fire Protection Maintenance - ANNUAL Recreational 7611 Other .., 9,'T 0 n Sparklers 1 Fire Alarm 0 ❑ ❑ ❑ I 1 [ Sprinkler System Installatio Hood Cleaning 0 ❑ ❑ ❑ 1 I 0 Standpipes (Sprinkler Sys) Hood Suppression 0 ❑ ❑ ❑ 1 J 7 Torch Roofing/Tar Kettle E Fire Alarm Installation I Waste Tire Storage ANNUAL 7 Fire Pumps Fire Works Flammable Application- ANNUAL ( Valuation of Project Fuel Tanks 0 Other: I Contractor Company Signature Registered Y/ N 1 Fee Current I Y/ N Address I I License # ELECTRICIAN Company Signature Registered Y / N . 1 Fee Current I Y / N I Address I I License # PLUMBER Company I Signature Registered Y / N I Fee Current I Y/ N I Address I 1 License # I MECHANICAL Company I Signature Registered Y/ N 1 Fee Current I Y/ N 1 Address I I License # I OTHER Company I Signature Registered Y / N 1 Fee Current 1 Y/ N I Address License # Directions: -e rd co Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)