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s�aaao-oo2o City of Zephyrhills Fire <br /> Permit Appiication F�'$�3 <br /> Date Received j — _ �� <br /> Phone Contact for Pertnit � � <br /> Owner's Name � �s � � �� � <br /> Owners Phone Number � <br /> Owners Address � 6 �' ,�/� � y <br /> Fee Simple Ttleholder Name �� � �� <br /> �----- TiUeholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address - -' ,S' � �. �� <br /> Sub Division <br /> Lot # <br /> Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � <br /> � Fumigatio� Tent <br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Faciliry) ANNUAL <br /> � Controlled Bum � <br /> � Hood Installation <br /> Emergency Generator < 30 kw � <br /> � Emergency Generator> 30 kw �P/Natural Gas-Installation <br /> � Fire Protection Maintenance -ANNUAL a LP/Natural Gas-ANNUAL Sale �� � <br /> � / � <br /> Places of Assembly-ANNUAL <br /> ❑ � emi � er <br /> Sprinkler � � � � - <br /> ❑ Recreational Bum <br /> Fire Alartn � � � � � <br /> ❑ Sparklers <br /> Hood Cleaning � � � � <br /> � � �� ❑ Sprinkler System Installations <br /> Hood Suppression p � <br /> � Standpipes (Sprinkler Sys) <br /> Fire Alartn Installation � <br /> � Torch Roofing/Tar Kettle <br /> Fire Pumps � <br /> Fire Works <br /> Waste Tire Storage ANNUAL <br /> � Flammable Application- ANNUAL <br /> � Fuel Tanks Valuation of Project <br /> Q Other: <br /> Contractor - � � � <br /> Signature ' Company � <br /> Registered Y/ N Fee Current Y <br /> Address <br /> License # � <br /> ELECTRICIAN <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # � <br /> PLUMBER <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # � <br /> MECHANICA <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> • License # � <br /> Directions: � °� -� • <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 wor{c 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 htt ://a <br /> � P ppraiser.pascogov.com) <br />