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r's-�so-oo2o City of Zephyrhills Fire <br /> Permit Application Fax-813-780-Op21 <br /> Date Received <br /> . t Phone Contact for Pertnit �� ��� <br /> Owners Name �� � �� <br /> Owners Phone Number <br /> Owners Address <br /> Fee Simple Titleholder Name � � � <br /> Fee Simple Titleholder Address Titleholder Phone Number <br /> Job Address � 1 — j� �"7D� � � <br /> Sub Division <br /> Lot # � <br /> Parcel # <br /> � Bio-Hazard Vyaste Storage - ANNUAL � ' <br /> � Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum <br /> � Hood Installation <br /> Emergency Generator < 30 kw � <br /> � Emergency Generator> 30 kw �P/Natural Gas-Installation <br /> � Fire Protection Maintenance - ANNUAL � �P�Natural Gas-ANNUAL Sale <br /> � Places of Assembly-ANNUA ��l� � <br /> ❑ rTy emi � er ' / � • I <br /> Sprinkler � � � ❑ � <br /> ❑ Recreational Bum <br /> Fire Alartn � � � <br /> ❑ �� � Sparklers <br /> Hood Cleaning p � � �� � <br /> � ❑ � �� � Sprinkler System Installations <br /> Hood Suppressian � <br /> � Standpipes (Sp�nkler Sys) <br /> Fire Alarm Installation � <br /> � Torch Roofing/Tar Kettle <br /> Fire Pumps � <br /> � Waste Tire Storege ANNUAL <br /> Fire Works <br /> � Flammable Application- ANNUAL <br /> � Fuel Tanks Valuation of Project <br /> Q Other: <br /> Contractor <br /> Signature Company ` j�o� U �, 7 �� �, � GG � <br /> Address <br /> Registered Y/ N Fee Current Y/ N <br /> ELECTRICIAN License# Z�G,�y�p�G—�—I <br /> Signature Company <br /> Address <br /> Registered Y/ N Fee Current Y/ N <br /> PLUMBER License # r <br /> 3ignature Company <br /> Address <br /> Registered Y/ N Fee Current Y/ N <br /> �AECHANICAL License # <br /> iignature Company <br /> Address Registered Y/ N Fee Current Y/ N <br /> )THER <br /> License # <br /> ignature Company <br /> Address Registered Y/ N Fee Current Y/ N <br /> irections: License # <br /> Fill out application completely <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contrect with owner) <br /> If over $2500, a NoGce 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 h //a raiser.pascogov.com) <br /> � ttP� PP <br />