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�:iaaso-oozo Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received `..3 " Phone Contact for Permit �� � <br /> Owner's Name Ci¢,�/ � -� Owners Phone Number O�.3 �a 3 p� <br /> Owner's Address v�'�j Q�"� ,�E�C- r ��f �. <br /> Fee Simple Titleholder Name Titleholder Phone Number �� C� �� <br /> Fee Simple Titleholder Address <br /> Job Address � <br /> Lot # <br /> Sub Division <br /> Paroel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> a Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> Q Fire Protection Maintenance - ANNUAL a Places of Assembly-ANNUAL <br /> ❑ [L�'y] emi � er ❑ <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm � O ❑ ❑ C� � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Instaliations <br /> Hood Suppression �❑ � ❑ C� a Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL <br /> � Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor ' <br /> Signature <br /> Company <br /> Registered Y! N Fee Current Y/ N <br /> Address <br /> License # <br /> ELECTRICIAN <br /> Company <br /> Signature I Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER <br /> 5ignature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> 1AECHANICA <br /> 3ignature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> )THER <br /> iignature Company `�, � <br /> C <br /> Registered / N Fee Current N <br /> Address <br /> License # <br /> )irections: � ��� <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. Paroel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />