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s�3-�so-oozo City of.Zephyrhills'Fir:e- FaX-8�aasaoo2i <br /> Permit Application . <br /> Date Received ^ - Phone Contact for Pertnit <br /> Owners fVame � Owners Phone Number ��. � <br /> Owner's Address �l \ . Y � <br /> Fee Simple TiUeholder Name Titleholdec Phone Number �� C� <br /> Fee SimpleTitleholderAddress <br /> Job Address C Lot# � <br /> Sub Division Parcel# '� ' Z -�I �' <br /> � Bio-Hazard Waste Storege - ANNUAL � Fumigation Tertt <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (fier 11 or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installatlon <br /> � Emergency Generetor < 30 kw � LPMatura! Gas-Installation <br /> Emergency Generator> 30 kw LP/Natural Gas-ANNUAL Safe <br /> � Fre Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL �/ K 1' <br /> �y emi �n er � ;� l � <br /> 5prinkler � ❑ � ❑ RecreaUonai Bum <br /> Fire Alarm � O � ��� � Sparlders <br /> Hood Cleaning � O ❑ ❑� � SprinklerSystem Installations <br /> Hood Suppression � O � ��"� Standpipes (Sprinkler Sys) <br /> � Fre Alartn Installation Q Torch Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Othe� <br /> Contractor Company /� <br /> Signature Reglstered N Fee Curtent N <br /> AddFess License # <br /> ELECTRICIAN Company <br /> Signawre ` Registered Y/ N Fee Current Y/ N <br /> Address license # <br /> PLUMBER Company <br /> Signature Regtstersd Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> S[gnature Registered Y/ N Fee Current Y/ N _ <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y! N <br /> Address • License # <br /> . �.�... .r t�� -_ _----- � —.,-�..� <br /> Directions: ' <br /> FII out application completely. <br /> Owner 8� Contractor sign back of appiication, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencemerrt is 2quired.(Mechanical woric over $50D0) <br /> Supply two (2) sets af drawings wfth applicable documenta6on <br /> Ailow 10-14 days for review after submfttal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />