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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Rer,oived • Phone Co�tact for Permit �_] �� Owner's Name Z�j� �/LL.s �]J�E/�R �� Owner's Phone Number �� Owner's Address ��S'�� AIL Lv,!/ Fee Simple Titleholder Name TiUeholder Phone Number �� Fee Simple Titleholder Address Job Address G E�N ,� 1 L Z S C I MEYl7 � � ��`�� L� ,�L (/� Lot # � Sub Division Parcel # � 8io-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm F�chaust Kitchen Hood/Duct Q Hazardous Material (Tier II or RQ Facility) ANNUAL � Controlled Bum � Hood Installation � Emergency Generator < 30 kw � LP/Natural Gas-Installation � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL �� �y emi �n er /1/ F� Sprinkler � ❑ ❑ ❑ � � Recreational Bum —1� � � Fire Alarm � ❑ ❑ �( � � Sparklers Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) � Fire Alarm Installation � Toroh Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application- ANNUAL Valuation of Project � Fuel Tanks Q Other. Contractor ��' � Company Signature i��/G � Registered Y/ N Fee Current Y/ N Address License # ELECTRICIAN Company Signature � 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 compietely. Owner & Contractor sign back of applicatlon, 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 appiicable documentation Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com)