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s�saea-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> -- Permit Application <br /> Date Received Phone Contact for Pertnit / 3 7� �S� <br /> Owner's Name ONmers Phone Number C_�L�LJ �� <br /> o�,erg a� 3'%3 0 ��� �� �/��` Ov Z e r` Il � l� S �'L.. 3 3.�� Z <br /> Fee Simple TitlehWder Name � 0`�' Z� hyrh i rf5 Titleholder Phone Number / 3 7g� 6�Z <br /> Fee Simple Titleholder Address <br /> Job Add�ess �� �� '� /�� h� � �� h r i l�s �' L. Lot # � <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Terrt <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum o Hood Installation <br /> � Emergency Generator < 3p kw � LPMatural Gas-Installation <br /> � Emergency Generator > 30 kw I Gas-ANNUAL Sale <br /> � Fire Protection Mairrtenance - ANNUAL Places of Assembly-ANNUAL <br /> � � � <br /> Spri�kler � ❑ ❑ ❑ ! f �/j� � s <br /> � / l(i <br /> Fire Alarm � ❑ ❑ ❑� � Sparklers J l <br /> ! <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installatio�s <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation a Torch Roofing/Tar Kettle <br /> Fire Pumps Q Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- M�IUAL Valuation of Project <br /> Fuel Tanks <br /> Q t r: <br /> Contractor Company <br /> Signature Registered Y/ N Fee Curtent Y/ N <br /> Address License # <br /> ELECTRICIA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address Lioense # <br /> PLUMBER Compa�Y <br /> Signature Registered Y/ N Fee Cument Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signawre Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER �Pa�Y <br /> signan,re Regiscered Y/ N Fee currern Y/ N <br /> Address License # <br /> Directions: <br /> Fill out apptication completely. <br /> OHmer & Contractor sign back of appliption, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Nodce of CommencemeM is required (Mechanical w+ork over $5000) <br /> Supply two (2) sets of drawings with applipble documentation <br /> Allow 10-14 days for review after submittal date. Paroel #- obtained from Properly Tax Notice (http://appraiser.pascogov.com) <br />