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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Receiv�!d �� f 7 //� Phone Contact for Permit ���� <br /> , <br /> Owner's Name L� i✓ ^ �G �✓ ��",� Owners Phone Number C� C� � <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number ��� � <br /> Fee Simple Titleholder Address <br /> Job Address ,�U � � � r �� <br /> Lot # <br /> Sub Division Paroel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator> 30 kw a LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> ❑ � emi � er � <br /> Sprinkler O ❑ ❑ Recreational Bum <br /> Fire Alartn � � ❑ ❑ �� � Sparklers <br /> Hood Cleaning ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ O C� � Standpipes (Sprinkler Sys) <br /> a Fire Alarm installation � Torch RoofinglTar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor Com an — <br /> _ p y `— �r rc � e <br /> Signature �� - Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN <br /> Company <br /> Signature � Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address 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 work over $5000) <br /> Supply two (2) sets of drewings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />