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813- 780 -0020 /(0 -7-- City of Zephyrhills Fire. Fax- 813-780 -0021 Permit Application Date Received I I Phone Contact for Permit ) nets Name I � f g � , N ,,,.,, jf I Owner's Phone Number I g/i 1 ?/s I 1 a Z-273> Z-273> 2 e ner's Address I S 7'L/' e j"H S s Fee Simple Titleholder Name Titleholder Phone Number I I I Fee Simple Titleholder Address Job Address I : :.. °: Sub Division I Lot# aw Parcel # Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent I Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL Controlled Bum I I Hood Installation I Emergency Generator < 30 kw I LP /Natural Gas - Installation Emergency Generator> 30 kw I LP /Natural Gas - ANNUAL Sale 1)44.... Fire Protection Maintenance - ANNUAL I Places of Assembly - ANNUAL I ILttrlyl 'Semi' IAnI Uther Sprinkler ❑ ❑ ❑ Recreational Bum Fire Alarm 7 ❑ ❑ (X1 1 Sparklers Hood Cleaning I ❑ ❑ ❑ 1 I Sprinkler System Installations Hood Suppression ❑ ❑ ❑ I I Standpipes (Sprinkler Sys) Fire Alarm Installation I I Torch Roofing/Tar Kettle Fire Pumps I I Waste Tire Storage ANNUAL Fire Works Flammable Application- ANNUAL E I Valuation of Project Fuel Tanks Other: I .,. ..:_!.,r.,. i.k�. ,r:: ...u..ri. ii=.d.k1;iC;;.,n. wa, �..a.: Contractor Company � �� Signature S� -advciy C j i Registered Y / N Fee Current 1 Y / N Address I I License # ELECTRICIAN Company Signature Registered Y / N j Fee Current I Y / N I Address I II License # PLUMBER r Company Signature I Registered Y/ N ] Fee Current I Y/ N I Address I 1 License # MECHANICAL Company Signature Registered Y / N j Fee Current I Y / N I Address I I License # OTHER Company Signature Registered Y / N j Fee Current I Y / N - I Address I 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)