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813-780-0020 City of Zephyrhills Fire <br /> Fax-813-780.0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit ��� <br /> Owner's Name p���{/- ��.,v� a.r �1 J f �� ��' <br /> Owner's Phone Number <br /> Owner's Address � � �� <br /> Fee Simple Titleholder Name r� �� <br /> Titleholder Phone Number L <br /> Fee Simple Titleholder Address <br /> Job Address � <br /> Lot # <br /> Sub Division <br /> Par�el # <br /> � Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent ' <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier il or RQ Faciliry) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw <br /> � LP/Naturai Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> ❑ � emi � er ❑ <br /> Sprinkler O ❑ ❑ Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning �❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression �❑ � p�� � Standpipes (Sprinkler Sys) <br /> � Fire Alarm installation � Torch Roofinglfar Kettle <br /> � Fire Pumps a Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL <br /> Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> a ..� r... �, x'• . � . �.na '.?.a. �Sa .��'tlsT � ��'r'^ m, �. e . <br /> CO�tfaCtOf � '" ' " . - <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> ELECTRICIAN <br /> Signature � <br /> Company <br /> Registered � r i ni � Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER <br /> Signature <br /> Company <br /> Registered I Y� N I Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICA <br /> Signature <br /> Company <br /> Registered I T% ry I Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER <br /> Company n � p�.se LL �° <br /> Signature ��1 Registered / N� Fee Current �/ N <br /> Address <br /> . �� ����.': .:,.,, : License # S'��J do4ri'S9G <br /> Directions: _ .. �...5 � »:..�«..�, ,.m...�.. ...�.._..,,;.:<�: . ... �nz ; ��=.r� v: ' <br /> �,;.,.�..�., < ,��,,,�.�... , . .�.. .. .. .. ; ;�� . <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 dxumentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:!/appraiser.pascogov.com) <br />