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- 813;76G City of.Zephyrhills -Fire O 1 ' Fax- 813 - 780 -0021 <br /> 'Permit Application <br /> Date Received Phone Contact for Permit <br /> Owner's Name . - _-ArAraUr t9 /��fizai'<UM, Owner's Phone Number I I I <br /> Owner's Address / P A i, is I- Cil.: A • ■ I -.1 — , ,' <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitleholder Address I <br /> Job Address •5 3 r - I Lot # <br /> Sub Division Parcel # <br /> El Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier I1 or RQ Facility) ANNUAL <br /> El 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 /> I ✓I Fire Protection Maintenance - ANNUAL = Places of Assembly- ANNUAL <br /> • <br /> Iotriy) !Semi' ®h'ilrl� <br /> Sprinkler n ❑ ❑ 1' n Recreational Bum <br /> 1 Alarm ❑ ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression JJ ❑ ❑ ❑ 1 I n Standpipes (Sprinkler Sys) <br /> I - 1 Fire Alarm Installation = Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> n Flammable Application- ANNUAL l I Valuation of Project <br /> n Fuel Tanks <br /> n Other: I <br /> Contractor Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I 1 License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y / N I Fee Current I Y / N j <br /> Address I I License #. I <br /> PLUMBER Company <br /> • <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address I I ' License # I I <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current I Y / N J <br /> Address I I License # <br /> OTHER Company <br /> Signature Registered Y/ N . 1 Fee Current I Y/ N I <br /> Address License # <br /> Directions: <br /> • <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 /> • <br />