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813 -780 -0020 City of Zephyrhills Fire <br /> Fax - 813 -780 -0021 <br /> Permit Application <br /> Date Received r <br /> 1 Phone Contact for Permit <br /> Owner's Name Owners Phone Number. 1 1 9 Lcryo <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number 1 <br /> Fee Simple Titleholder Address <br /> Job Address Lot #I <br /> Sub Division <br /> Parcel # <br /> ., � �. ... <br /> l I Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> !Carly' 'Semi J" Fi I Uther <br /> Sprinkler 7 ❑ ❑ ❑ I I Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I Sparklers <br /> Hood Cleaning ® ❑ ; ❑ I I n Sprinkler System Installations <br /> Hood Suppression [2L❑ X ❑ I 1 1 1 Standpipes (Sprinkler Sys) <br /> I I Fire Alarm Installation I I Torch Roofing/Tar Kettle <br /> 7 Fire Pumps n Waste Tire Storage ANNUAL <br /> I 1 Fire Works <br /> Flammable Application- ANNUAL 1 ( Valuation of Project <br /> - <br /> � ; , I � Fuel Tanks <br /> n Other: 1 <br /> . <br /> C ontractor , . ., . . . .. ... u.... .. . M k., . �...�__ „., <br /> Company <br /> Signature <br /> Registered Y / N I Fee Current I Y / N I <br /> Address ( I License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I <br /> 1 License # <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address I I License # I <br /> MECHANICAL ( Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I 1 License # I <br /> OTHER , Company _ _ <br /> Signature r' v�l Registered 9 mum Fee Current 411101011 <br /> Address l 1 License # 1 <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 />