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��aaso-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received �Z l Phone Contact for Pertnit � �'�L <br /> �v <br /> Owner's Name w� ��� Owners Phone Number ��✓ � t� � 7 <br /> Owner's Address ��� ,��c,a� � <br /> Fee Simple Titleholder Name Titleholder Phone Number � �� <br /> Fee Simple Titleholder Address <br /> Job Address `�� ��� � Z' �( 6 �V T l � 5- i � Lot # � <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw a LPlNatural Gas-Installation <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y em� �n er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ � � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System installations <br /> Hood Suppression � ❑ ❑ ❑ � � Stand i <br /> p'pes (Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL r--� Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor ,/� Company �. cNi <br /> Signature (J � Registered Y/ N Fee Current Y/ N <br /> Address ,�j '7( w'.• vtf �J� License# E Oor>(( <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 <br /> Company <br /> Signature Registered Y/ N Fee Cument 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:/lappraiser.pascogov.com) <br />