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s�s-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application � ' i <br /> Date Recehred - � ,/ Phone Contact for Pertnit C��:.�G.�,.J � �� <br /> Owner's Mame Owners Phone Number .5 Z �f>� �'Q <br /> Owner's Address <br /> Fee Simple Titieholder Name Titleholder Phone Number �� �� �� <br /> Fee Simple Titleholder Address <br /> Job Address ���� �p � � � ` � � 3 3 ,5�� 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 -T/ � j� U � J <br /> � r• <br /> Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er • • <br /> Sprinkler ❑ ❑ ❑ � � Recreational Bum � fS� ` <br /> Fire Alarm � ❑ ❑ ❑ � 0 <br /> .� �- %',� <br /> Hood Cleaning � ❑ ❑ ❑ � Sprinkler System installations �- , <br /> Hood Suppression � ❑ ❑ ❑ � oioes (SoonWe s -- - � <br /> � Fire Alartn Installation � Torch RoofinglTar Kettle � � S���� M'� ���� <br /> � Fire Pumps � Waste Tire Storage ANNUAL �,- �,L�'""' I <br /> � Fire Warks � <br /> � Flammable Application- ANNUAL � J Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor Company <br /> Signature � Registered Y/ N Fee Current Y/ N <br /> Addres C License # <br /> ELECTRICIAN Company <br /> Signature � Registered Y/ N Fee CuRent Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contrector 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 iwo (2) sets of drawings with applicable documentation <br /> Ailow 10.14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />