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813-780-0020 City of.Zephyrhills - Fax- 813 -780 -0021 Permit Application _ Date Received Phone Contact for Permit l I Owner's Name �(li4I4' • jv a h or / Owner's Phone Number Owner's Address .(7/1 a L Z L bA ? rrj -i's „cz. 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 n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL FT Controlled Bum n Hood Installation n Emergency Generator < 30 kw n LP /Natural Gas- Installation Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL IUtnyI 1Semi ow Otner Sprinkler n ❑ ❑ ❑ n Recreational Bum Fire Alarm n ❑ ❑ ❑ I l n Sparklers Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations Hood Suppression L4 ❑ X ❑ I 1 n Standpipes (Sprinkler Sys) n Fire Alarm Installation n Torch Roofing/Tar Kettle F:R Fire Pumps n Waste Tire Storage ANNUAL Fire Works n Flammable Application- ANNUAL I I Valuation of Project El Fuel Tanks n Other: I Contractor Company Signature Registered Y/ N j Fee Current I Y / N Address 1 I License # ELECTRICIAN Company Signature Registered Y/ N I Fee Current I Y/ N j Address I I License # PLUMBER Company Signature Registered Y/ N 1 Fee Current I Y/ N Address I 1 License # MECHANICAL Company Signature Registered Y/ N I Fee Current 1 Y/ N Address I I License # OTHER ( Company vp L Eee , . _ .,e L Signature Registered 115>f� Fee Current 4lir , N Address License # .� 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 (http: / /appraiser.pascogov.com)