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813 780-0020 City of Zephyrhills Fire Fax-aisago-ooz� <br /> Permit Application <br /> Date Received �/��.3'��j/ Phone Contact for Pertnit l 3 �t ?� �� <br /> Owners Name L' �/~ - � Owners Phone Number ���� <br /> Owners Address O � .�V �V� - � � r lll� � � �'�/ <br /> Fee Simple Titleholder Name Titleholder Phone Number C� �� <br /> Fee Simple Tilleholder Address <br /> � <br /> Job Address � <br /> Lot # <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storege - ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Faciliry) ANNUAL <br /> a Controlled Bum a Nood Installation <br /> a Emergency Generator < 30 kw a LP/Natural Gas-Installation <br /> a Emergency Generator > 30 kw a LP/Natural Gas-ANNUAL Sale <br /> a Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ p � � RecreaUonal Bum <br /> Fire Alarm � ❑ ❑ O C� a Sparklers �! j/�" <br /> 1 <br /> Hood Cleaning � p p O� a Sprinkler System Installations <br /> Hood Suppression � t ❑ X ❑� a Standpipes (Sprinkler Sys) � p, �( <br /> � � � � � <br /> Fire Alartn Installation � Toroh Roofing(Tar Kettle � <br /> Q Fire Pumps � Waste Tire Storage ANNUAL <br /> a Fire Works <br /> � Flammable Application-ANNUAL D• � Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor � Company � - � /.1- - �� r� f;yL�,� <br /> Signature Registered Y/ N Fee Current Y/ nl <br /> Address �?p/ .,�sG �rcrr �4'" - "�' � License# � �y�3�1 �v� (' <br /> c�oc� �o � <br /> ELECTRICIAN <br /> Company <br /> Signature Registered Y/ N Fee CuRent Y/ N <br /> Address License # <br /> PLUMBER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICAL <br /> Company <br /> 5ignature Registered Y/ N Fee Current Y/ N . <br /> Address License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> Directions: <br /> Fill out application completely <br /> Owner & Co�tractor sign 6ack of application, notarized (Or, copy of signed contract with owner) <br /> ff over $2500, a Notice of Commencement is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentafio� <br /> Allow 10-14 days for review after submittal date. Paroel #- obtained from Property Tax Notice (httpl/appraiser.pascogov.com) <br />