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813-780 -0020 City of.Zephyrhills' Fir e �C v4 Fax - 813 - 780 -0021 Permit Application Date Received Phone Contact for Permit Owner's Name CAA ent . Owner's Phone Number 113 7 Z 77 7 Owner's Address I Cis -iL- ,2Z-Vv / QAy .- X, l fS Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address I Job Address Lot* Sub Division Parcel # n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent F Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL n Controlled Bum n Hood Installation n Emergency Generator < 30 kw n LP /Natural Gas - Installation n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL Jutrlyp !berm' LW Other Sprinkler n ❑ ❑ ❑ n Recreational Bum Fire Alarm E] ❑ ❑ ❑ I ( I Sparklers Hood Cleaning El ❑ ❑ ❑ I 1 n Sprinkler System Installations Hood Suppression 123 ❑ ❑ 1 I n Standpipes (Sprinkler Sys) n Fire Alarm Installation n Torch Roofing/Tar Kettle M Fire Pumps = Waste Tire Storage ANNUAL Fire Works Flammable Application- ANNUAL 1 Valuation of Project Fuel Tanks In Other: I "aT' Contractor Company Signature Registered Y / N I Fee Current I Y/ N Address I 1 License # ELECTRICIAN Company Signature Registered Y/ N 1 Fee Current I Y/ N Address I I License* PLUMBER Company Signature Registered Y/ N 1 Fee Current I Y/ N Address 1 I License # MECHANICAL Company Signature Registered Y / N 1 Fee Current I Y / N j Address 1 ] License # ) I OTHER Company i f, L Signature Registered L�Illird Fee Cu .t t LIMB. Address License # TM ro: Directions: 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 (httpJ /appraiser.pascogov.com)