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813 - 780 -0020 City of Zephyrhills Fire r, , . Fax -813 -780 -0021 <br /> Permit Application ) <br /> Date Received 1 1 Phone Contact for Permit 1 727 1 1 , ©I1� <br /> � <br /> Owner's Name I W bO / WSW Owner's Phone Number ( 1 I I <br /> Owner's Address I <br /> Fee Simple Titleholder Name I Titleholder Phone Number I 1 I I <br /> Fee Simple Titleholder Address I <br /> Job Address &ib l -- 6.4 a- 41-14) <br /> Lot # <br /> Sub Division I Parcel # I <br /> El Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> El Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Bum I Hood Installation <br /> n Emergency Generator < 30 kw = LP /Natural Gas - Installation <br /> El Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> W71 M I J Other <br /> Sprinkler E ❑ ❑ ❑ = Recreational Bum <br /> Fire Alarm E ❑ ❑ I I n Sparklers <br /> Hood Cleaning Er 1Y' / ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation I1 Torch Roofing/Tar Kettle <br /> ri Fire Pumps I Waste Tire Storage ANNUAL <br /> I Fire Works <br /> Flammable Application- ANNUAL I I Valuation of Project <br /> Fuel Tanks <br /> Q Other. I <br /> Contractor Company <br /> Signature Registered Y/ N I Fee Current I Y / N j <br /> Address I I License # ( <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N 1 Fee Current I Y/ N j <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y / N ] Fee Current I Y / N <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N J Fee Current I Y/ N I <br /> Address I / f/� ` � it <br /> /> I License # �,-� <br /> OTHER U B \ ! ODV (I /I ' 39� Company � N F ee Current nt <br /> Signature r / Registered Y / N F ee Current <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 />