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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Pertnit Application <br /> Date Received (p Phone ConWct for Pertnit ��� � <br /> � <br /> Owners Name 1'� Q3S�ph Owner's Phone Number ��� � <br /> Owners Address � �6 � � � �� <br /> Fee Simple Titleholder Name Titleholder Phone Number � �� <br /> Fee Simple Titleholder Address <br /> u ,.. . , . ,+.. � <br /> Job Address � v � Lot # � <br /> Sub Division Paroel # <br /> a BiaHazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Naturai Gas-Installation /� (� <br /> � Emergency Generetor > 30 kw � LP/Natural Gas-ANNUAL Sale � y( % <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL ' � i I� (� <br /> � emi �n er J�i( <br /> Sprinkler � O ❑ ❑ � a Recreational Bum I � , �� � ��� <br /> Fire Alarm � O ❑ ❑ � � Spa�lclers �� � � � <br /> Hood Cleaning � ❑ ❑ ❑ � � prinkler System Installations � <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Toroh Roofingffar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Z t�d Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature I 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 /> MECHANICA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER .�� Company e L <br /> Signature '� lk'� �� � C. Registered Y/ N Fee Current Y/ N <br /> Address ' License # � <br /> Directions: • ` ` . <br /> Fi�l 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 />