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. 813-780-0020 City of.Zephyrhills Fire. Fax-813-7813-0021 Permit Application Date Received Permit Phone Contact fo r Owner's Name Owner's Phone Number ` I I I I Owner's Address Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address , W - :� -- : t.,- ,.. ,'�'�� ry� � : -' �.-�^ ... Job Address Lot TM Sub Division Parcel # Bio-Hazard Waste Storage - ANNUAL I I Fumigation Tent Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL 1 — I Controlled Bum Hood Installation Emergency Generator < 30 kw n LP /Natural Gas - Installation Emergency Generator> 30 kw Ii LP /Natural Gas - ANNUAL Sale Fire Protection Maintenance - ANNUAL I 1 Places of Assembly- ANNUAL IUtrlyl Semi' i " "" Uther Sprinkler ❑ ❑ ❑ I Recreational Bum Fire Alarm 1 ❑ ❑ ❑ Sparklers Hood Cleaning n ❑ ❑ ❑ I Sprinkler System Installations Hood Suppression I ❑ ❑ ❑ 1 I Standpipes (Sprinkler Sys) Fire Alarm Installation Torch Roofing/Tar Kettle Fire Pumps 1 I Waste Tire Storage ANNUAL Fire Works Flammable Application- ANNUAL ( Valuation of Project Fuel Tanks �I Other: I Contractor Company Signature Registered Y / N Fee Current Y / N Address I License # I ELECTRICIAN Company Signature Registered Y / N Fee Current Y / N - Address I License # I PLUMBER Company Signature Registered Y / N Fee Current Y / N Address License # MECHANICAL Company Signature Registered Y / N Fee Current Y / N Address 1 License # OTHER Company Signature Registered Y / N I Fee Current 1 Y / N Address 1 License # .....,- wwuaaf.w...wwwa,= - - Directions: u 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)