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s�s-�so-oo2o Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received ��^ Z Z—/( Phone Contact for Permk �f! <br /> � � �� z� <br /> Owner's Name — T � 5� „,r Owner's Phon ' � —'—' <br /> Owner's Address <br /> Fee Simple Titleholder Name TiUeholder Phone Number �� � <br /> Fee Simple Titleholder Address ----- <br /> Job Address �O �,�. �( � Lot # � <br /> Sub Division Paroel # <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 � LPlNatural Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale �U� <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL �' <br /> �y emi �n er �(��j;� <br /> Sprinkler � ❑ ❑ ❑ B � Recreational Bum �� rr <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning �❑ � ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> a Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor Company � T „�, �,� L <br /> Signature Registered N Fee Current Y/ N <br /> Address CZ License # � ,S' <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 Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: � <br /> Fill out application completely <br /> Owner & Contrector sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical woMc 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 />