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813-780 -0020 City of Zephyrhills Fire. 4 �� Z �� Fax - 813- 780-0021 _ <br /> Permit Application - =-- <br /> Date Received - Phone <br /> eceived <br /> Larseameassonastaraxv <br /> Phone Contact Permit for Pet <br /> Owners Name <br /> 1 i1a C V5 1 Owners Phone Number - 1 13 4 - 71 <br /> )` /� <br /> Owners Address I .p A" , l S 6 <br /> Fee Simple Titleholder Name <br /> I l Titleholder Phone Number I l 1 11 <br /> Fee Simple Titleholder Address <br /> Job Address � Lot# <br /> 1 I I <br /> 1 Parcel # <br /> Sub Division <br /> ED Bio-Hazard Waste Storage -ANNUAL a Fumigation Tent <br /> I Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Bum ED Hood Installation <br /> El Emergency Generator < 30 kw ED LP/Natural Gas-Installation <br /> El Emergency Generator> 30 kw n LP/Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> El . ®I cnner I <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm - ❑ ❑ ❑ Sparklers <br /> N <br /> Hood Cleaning ❑ ❑ 1 1 n Sprinkler System Installations <br /> Hood Suppression 1:1 ❑ ❑ <br /> I I I1 Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation I Torch Rooting/Tar Kettle <br /> FR Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I Valuation of Project <br /> R Fuel Tanks I <br /> Contractor ti 1 a - Company Y/ N Fee Current Y/ N <br /> Signature 4111,V1/411111) <br /> ,l�∎... A Registered I <br /> Address " License # <br /> � h. _ � el c 1 <br /> ELECTRICIAN Cony <br /> Signature Registered Y/ N 1 Fee Current I Y/ N 1 <br /> Address I .1 License # <br /> PLUMBER Company I <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N <br /> Address I I License # ( I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N f Fee Current I Y/ N I <br /> Address f I License # I <br /> OTHER Company I <br /> Signature Registered l Y/ N I Fee Current L Y/ N <br /> Address License # <br /> N•..:'" _ ^T- 2?cTrvv`sF = .�^m�^+ ;R.'Y5:"^ ^^^L't?F.'wTT3:: » x _ ..x . nx'c ^ [ — r. <. -,.� -_ <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> tf over $2500. a Notice of Commencement is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation Tax (htlpJlappreiser.pascogov.com) <br /> Allow 10-14 days for review after submittal date. Parcel # - obtained from Property <br />