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s�3aso-oo2o City of Zephyrhills Fire <br /> Permit Application Fax-813-780-0021 <br /> Date Received � � Phone Contact for Permit ��__ �� <br /> L------.1 <br /> Owner's Name � � � <br /> � � Owners Phone Number <br /> Owners Address 67� � t V A Sa/ 1�� � k� <br /> s �. <br /> Fee Simple Titleholder Name • r �� <br /> Titleholder Phone Number u <br /> Fee Simple Titleholder Address <br /> Job Address 0� R Z J 1 k /� `•. � <br /> Lot # <br /> Sub Division <br /> -r , <br /> Paroel # <br /> � Bio-Hazard Waste Storage - ANNUAL � <br /> � Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) qNNUAL <br /> � Controlled Bum Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Naturel Gas-ANNUAL Sale <br /> � Fire Protection Maintenance -ANNUAL � �' <br /> Places of Assembly-ANNUAL <br /> ❑ �r y emi �n er ❑ � ( <br /> Sprinkler ❑ ❑ Recreational Bum � � `r <br /> Fire Alartn � O ❑ ❑� � Sparklers j <br /> Hood Cleaning � p p � r_� � <br /> ❑ � ❑ Sprinkler System Installation <br /> Hood Suppression ❑ ❑ ❑ Standpipes (Sprinkler Sys) <br /> a Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> � Flammable Application- ANNUAL <br /> � Valuation of Project <br /> Fuel Tanks <br /> [� Oth . <br /> Contractor °�'°�'� `'� _ - - <br /> Signature Company SA V A ' <br /> Registered Y/ N Fee Current Y/ N � <br /> Address <br /> License # �— <br /> ELECTRICIAN <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # �-- <br /> PLUMBER <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICAL <br /> 3ignature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # �— <br /> �THER <br /> >ignature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> )irections: <br /> License # �— <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 />