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813-780-0020 Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received � Phone Contact for Permit ��� <br /> , _. <br /> � � � � <br /> wner's Name � �,✓ t i�(" Owners Phone Number <br /> � � �� � <br /> wner's Address � � L. � <br /> 3e Simple Titieholder Na Titleholder Phone Number ��� <br /> �e Si older Address <br /> " � .a', x .�. : - . ,. _ i S <br /> �b Address / �"� � `'� � � G i(./ /^� Lot # � <br /> �b Division Paroel # <br /> o Bio-Hazard Waste Storegea ANNUAL a Fumigation Tent <br /> � <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> 0 <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Instailation /� <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL 5'ale � <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-AN�fUAL � �� �� �� 1 � <br /> � emi �n er ` c �" , � � <br /> Sprinkler � ❑ O ❑ � � RecreaUonal Bum ✓�'�� � ` n <br /> �i <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers �� <br /> --,�-�,���,""� � <br /> Hood Cleaning � ❑ ❑ O� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ O � � Standpipes (Sprinkler Sys) `;.�� <br /> � Fire Alartn Installation � Torch Roofingffar Kettle <br /> a Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> [�' Other: %�- r�, � o d. �� . � � „�,. - <br /> . � .> <br /> �ntractor � Company � '7'Y� ..,� <br /> gnature �� •'' Registered / N Fee Current Y/ N <br /> Address p — '�-�2v t�� L License # G��,�c7 � <br /> _ECTRICIAN Company <br /> gnature I Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> _UMBER Company <br /> gnature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ECHANICA Company <br /> gnature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> THER Company <br /> gnature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> rections: <br /> Fill out application completely <br /> Owner 8� Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical woiic over $5000) <br /> Supply two (2) sets of drawings with appiicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />