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s�saao-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received Phone Contact for Pertnit �� Owner's Name � 1 Owners Phone Number �� Owner's Address � S 'r� Fee Simple Titleholder Name TiUeholder Phone Number �� Fee Simple Titleholder Address Job Address 3 � J'"� � �Y� Lot # � Sub Division Parcel # � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent a Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL � Controlled Bum � Hood Installation � Emergency Generator < 30 kw /, ,` Q LplNatural Gas-Installation o C Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL �y emi �n er Sprinkler � ❑ ❑ O � � Recreational Bum Fire Alartn � ❑ ❑ ❑ � � Sparklers � %/ � �iC�' (� Hood Cleaning � ❑ ❑ �� Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) � Fire Alarm Installation � Torch RoofinglTar Kettle n Fire Pumps � Waste Tire Storage ANNUAL �� Fire Works � Flammable Application- ANNUAL Valuation of Project Fuel Tanks Q Other: Contractor /> Company Ye S Ut WA, ,n Signature Registered / N Fee Cu nt Y/ N Address License # ELECTRICIAN Company Signature I Registered Y/ N Fee Current Y/ N Address License # PLUMBER Company Signature Registered Y/ N Fee Current Y/ N Address License # MECHANICAL Company Signature Registered Y/ N Fee Current Y/ N Address License # OTHER Company Signature Registered Y/ N Fee Current Y/ N Address License # Directions: Fill out application completely Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:!/appraiser.pascogov.com)