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81`3- 780 -0020 City of Zephyrhills Fire 4 ( OV'(J Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received IJ1 Phone Contact for Permit l <br /> P- u'' <br /> Owner's Name i ) Owner's Phone Number <br /> Owners Address �Cl (, H IjL VO 7,/A 1 <br /> Fee Simple Titleholder Name Y Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address Lot # <br /> Sub Division I Parcel # <br /> n 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 /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL I �I Places of Assembly- ANNUAL <br /> �tttriyl fSemil E Uther <br /> Sprinkler ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ ( I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> n Flammable Application- ANNUAL I I Valuation of Project <br /> n Fuel Tanks <br /> n Other: <br /> Contractor �' y, /`IJ Com an <br /> r <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address <br /> License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address <br /> License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N J Fee Current I Y/ N <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER Company <br /> Signature Registered Y/ N j Fee Current I Y/ N <br /> Address <br /> License # <br /> DCt OnS a._,w � ., <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 />