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813.780 -0020 City of.Zephyrhills Fire 4 fro 36 Fax - 813- 780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> Owner's Name J // P / e h a S -c, r S 1 Owner's Phone Number i / 3 17 & oZ 3 S'/ <br /> Owner's Address Y 6 / (as II 4 /1 /3 / veil <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simpleritleholder Address I <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> FT Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> 0 Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw LP /Natural Gas - ANNUAL Sale <br /> I - 1 Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL <br /> man !Semi' Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum L4V <br /> Fire Alarm n ❑ ❑ ❑ I 1 n Sparklers <br /> ( 21 t fli..... <br /> Hood Cleaning E ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ ( I n Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> H Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> El Flammable Application- ANNUAL I Valuation of Project <br /> n Fuel Tanks <br /> 0 Other: I <br /> /CONIMENISUBSIMMESIF Contractor ie 1 , Company <br /> Signature / �/� Registered Y / N I Fee Current I Y / N I <br /> Address I I License # I <br /> ELECTRICIAN Company <br /> Signature I Registered Y / N i Fee Current I Y / N <br /> Address I I License # <br /> PLUMBER Company <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I ( . License # I I <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current I Y / N I <br /> Address I I License # <br /> OTHER Company <br /> Signature Registered Y / N j Fee Current I Y / N I <br /> Address Imenweammenu License # <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 (httpJ /appraiser.pascogov.com) <br />