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813- 780 -0020 City of Zephyrhills Fire * 1 0 1(C( Fax - 813 -780 -0021 Permit { � 2 �il � I Application Date Received I Phone Contact for Permit I I I I I I „ \ I . _ Owner's Phone Number I ( "10 \--I I. -I I R �L- Owner's Name � 1 -\ ` ,1 , S Owner's Address __ • , 0 , A `�+ • i Fee Simple Titleholder Name I I 1 Titleholder Phone Number I 1 1 1 1 I Fee Simple Titleholder Address I n /� - c' 1 h -� ` ,i ) 1 - f - Akt 1 g t) 1 L. )11 I Lot # ( I Job Address I �,h � w \� --�� ■ ► �i' " Sub Division I Parcel # I I El Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL E l Controlled Burn n Hood Installation In Emergency Generator < 30 kw n LP /Natural Gas - Installation n I Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale ri Fire Protection Maintenance - ANNUAL n P!ace:; cf Assemb!y- n lQtrly) (Semi) � Other I Sprinkler ❑ ❑ ❑ Recreational Burn Fire Alarm ❑ ❑ ❑ I 1 n Sparklers Hood Cleaning ❑ ❑ ❑ I I [] Sprinkler System Installations Hood Suppression n ❑ ❑ ❑ 1 I n Standpipes (Sprinkler Sys) E Fire Alarm Installation n Torch Roofing/Tar Kettle a Fire Pumps n Waste Tire Storage ANNUAL n Fire Works I I E Flammable Application- ANNUAL Valuation of Project El Fuel Tanks In Other: Contractor Company I Signature I Registered Y/ N I Fee Current I Y/ N I Address I I License # 1 I ELECTRICIAN Company I Signature Registered I_ Y/ N I Fee Current I Y/ N I Address ( I License # ( I - PLUMBER I Company I Signature I_ _I Registered Y/ N I Fee Current I Y / N I Address I I License # I MECHANICAL Company I Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # I OTHER Company I Signature Registered Y / N I Fee Current I Y/ N I Address I I License # ( I 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)