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a� xa8o-oozo City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received � Phone Contact for Permit �7 � C� <br /> Owners Name ' Owners Phone Number � 71 Zoy�� <br /> Owner's Address � �'.,� q �� 1/ <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> Job Address gf S � Lot # � <br /> Sub Division Parcel # <br /> a BiaHazarcl Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facii' NNUAL _\ <br /> � Controlled Bum � Hood Installation � <br /> � Emergency Generator < 30 kw � LPlNaturai Gas-Installation �(� � <br /> a Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL le // �� <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUA <br /> �y emi �n er <br /> Sprinkler � B1 ❑ ❑ � � Recreational Bum � � �`� <br /> Fire Alarm � ❑ ❑ � � � Sparklers � /�/ <br /> Hood Cleaning � � ❑ ❑� � Sprinkler System Installations � �) <br /> � v�� <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) p( <br /> � Fire Alarm Installation � Toroh Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � FlammableApplication-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor ''J Company ` <br /> Signature !/� Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature � Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Cument Y/ N <br /> Address 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 Mro (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:/lappraiser.pascogov.com) <br />