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� a�3��so-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received � Z� Phone Contact for Permit � �7 b� Owner's Name � Owner's Phone Number �� Owner's Address Fee Simple Titleholder Name Titleholder Phone Number �� Fee Simple Titleholder Address ✓ � Job Address L / / Lot # Sub Division Parcel # � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � 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 i // r y emi �n t er y� � �� Sprinkler � ❑ ❑ ❑ � Recreational Bum ' Fire Alarm � ❑ ❑ ❑ � � Sparklers Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) � Fire Alarm Installation � Torch RoofinglTar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � FlammableApplication-ANNUAL Valuation of Project � Fuei Tanks � Other• Contractor Company Signature Registered Y/ N Fee Current Y/ N Address License # ELECTRICIAN Company Signature Registered Y/ N Fee Current Y/ N Address License # PLUMBER � � �. _ / ,,. y- Company (� f Signature .�� Registered Y/ Fee Current Y/ Address � j — j�7'f'j � License # '�y � 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)