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813-780-'�',`J20 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Pertnit ��� � <br /> Owner's Name Chtr� S B�4+e ���G� Owners Phone Number �� � <br /> Owner'sAddress bti3 C>M« B Z.Epti"�{R�`��S ( �L <br /> Fee Simple Titleholder Name Titleholder Phone Number �] �� <br /> Fee Simple Titleholder Address <br /> Job Address Lot # � <br /> Sub Division Parcel # <br /> � BiaHazard Waste Storage - ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen HoodlDuct a Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Naturai Gas-Installation <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y e �n er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ � � Sparklers <br /> Hood Cleaning � O ❑� � Sprinkler System Instaliations <br /> Hood Suppression � ❑ ❑ ❑ � � Stand i <br /> p'pes (Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh Roofing/Tar Kettle <br /> � Fire Pumps a Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL r � 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/ NI 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 <br /> Signature Registered Y/ N Fee Current 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 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 />