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� si3aao-oozo City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received /Z ( Phone Contact for Pertnit j� J � fo �'S�iZ <br /> Owners Name �" 1� � Owners Phone Number �11 3 ��3 �O� Z� <br /> Owner's Address ? o� � V�'T �� l V� <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> Job Address � fJ�� �� u �/�J� Lot # � <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAI� ----� <br /> a Controlied Bum a Hood Instaliation ' <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Instaliation ��7 <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale �� <br /> � Fire Protection Maintenance - ANNUAL Q Places of Assembly-ANNUA �� <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum � <br /> Fire Alarm � � ❑ �9- � � Sparklers G, <br /> ��J <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations � <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) l � <br /> � Fire Alartn Instailation � Toroh Roofinglfar Kettle '`� I <br /> � F i r e P u m p s � W a s t e T i r e S t o r a g e A N N U A L �� <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor Company ��'• <br /> Signature (�� Registered Y/ N Fee Current Y/ N <br /> Address 7 6✓ , w .SY� License # � �°� J <br /> ELECTRICIAN Company <br /> Signature � 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 <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 ovmer) <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 />