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813-780 -0020 City of.Zephyrhills'Fire - -- _ .::. • Fax - 813-780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit J <br /> Owner's Name % l✓ f .. 7 Owners Phone Number 1 <br /> Owners Address S /2c) co/4 3L vb Ze yr`i1/4 FL <br /> Fee Simple Name Titleholder Phone Number <br /> Fee Simple 'Titleholder Address I I <br /> Job Address Lot* <br /> Sub Division Parcel # <br /> 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 /> I - 1 Controlled Bum I Hood Installation <br /> nl Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL • n Places of Assembly- ANNUAL <br /> 1LttnyI JsemiI FATill Usher <br /> Sprinkler GI ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm El ❑ ❑ ❑ L I ( I Sparklers <br /> Hood Cleaning 0 ❑ pf ❑ I I n Sprinkler System Installations <br /> Hood Suppression ❑ d ID . I n Standpipes (Sprinkler Sys) <br /> I - 1 Fire Alarm Installation � n Torch Roofing/Tar Kettle <br /> I Fire Pumps n Waste Tire Storage ANNUAL <br /> I Fire Works <br /> Flammable Application- ANNUAL ( , Valuation of Project <br /> Fuel Tanks <br /> El Other: I <br /> Contractor Company <br /> Signature Registered Y / N j Fee Current I Y / N j <br /> Address I License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N Fee Current I Y / N <br /> Address I I , License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N j <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N j Fee Current I Y / N <br /> Address I I License # <br /> OTHER �C9l" I�Jy�r�o,� �[ f,� 1 <br /> • <br /> Signature — Registered 40112 N f Fee Current CV N I <br /> Address <br /> 1 License <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 />