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813 - 780 - 0020 City of Zephyrhills Fire . 4 1 Fax - 813 - 780 - 0021 <br /> Permit Application I <br /> 1 <br /> Date Received 91'21 : 1 Phone Contact for Permit I 1 1 1 1 I <br /> Owner's Name l Owner's Phone Number NM Mal I <br /> Owner's Address Qq{ i7C >� .i k Vc-1 - , .'J 3-li L I <br /> Fee Simple Titleholder Name I J Titleholder Phone Number I I I <br /> Fee Simple Titleholder Address I I <br /> Job Address ' t - \ c 1 -T- • i - . ` i - * of # <br /> Sub Division Parcel # <br /> I Bio- Hazard Waste Storage- ANNUAL n Fumigation Tent <br /> D Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I - 1 Controlled Burn n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> El E - mergency Generator > 30 kw LP /Natural Gas - ANNUAL Sate <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly - ANNUAL <br /> (Qtrly) Semi) OM Other <br /> Sprinkler D ❑ ❑ ❑ n Recreational Burn <br /> Fire Alarm O ❑ ❑ ❑ ( I 0 Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I 1 n Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> D Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n F ire Pumps n Waste Tire Storage ANNUAL <br /> F ire Works <br /> n Flammable Application- ANNUAL I I Valuation of Project <br /> n F - uel Tanks <br /> Ti O ther: I I <br /> Contractor Company I <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address I I License # I <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 />