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si3aso-oo2o City ofZephyrhills"Fir.e• FaX-s�sasaoo2i <br /> Permit Appiicafion - <br /> y - Phone Contact for Pertnit � <br /> Date Received� <br /> Owner's Name � \ � +h � Owners Phone Number � �- � <br /> Owner's Address � ► � � � � � L �"" <br /> Fee Simple Tit{eholder Name TiUeholder Phone Number ��� <br /> Fee Simple Titleholder Address <br /> Job Address � � � � Lot# � <br /> Sub Division Paroel # Z � <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood tnstallatlon <br /> � Emergency Ge�erator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator > 3D kw � LP/Naturel Gas-ANNUAL Safe <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi � er � <br /> 5prinkler ❑ ❑ � Recreational Bum <br /> Fire Alartn o o ��� � Sparklers �� " <br /> Hood Cleaning � ❑ O �� � SprinWer System Installations '� � I <br /> Hood Suppression � O ❑ ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh Roofing/'far Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Othe � <br /> ConUactor Company � f - ; �� d ' ' m ' � ' �i <br /> Signature Registered N Fee Current Y N <br /> Add�ess License # £ <br /> ELECTRICIAN Company <br /> 5ignature ` Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fse Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/�l Fee Curtent Y/ N . <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: <br /> FII out application completely. <br /> Owner & Contrector sign back of application, notarized (Or, copy of signed conVact wfth owner) <br /> If over $2500, a Notice of Commencemerrt is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with appiicable documentation <br /> Allow 10-14 days for review after submittal date. Paroel #- obtained from Properry Tax Notice (httpJ/apprefser.pascogov.com) <br />