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a�saao-oozo City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Pertnit ���'� � v���' �,5 <br /> Owner's Name f� ; �l• Owner's Phone Number ���� <br /> Owner's Address (J ` � ,S � �L <br /> Fee Simple Titleholder Name Titleholder Phone Number ���� <br /> Fee Simple Titleholder Address <br /> Job Address ��p' � � Lot # � <br /> Sub Division Paroel # <br /> � Bio-Hazarcl Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL � <br /> �) <br /> � Controlled Bum � Hood Installation ��'"� ( ���; <br /> � <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation � •.�'!��( �^� �; /Y� � 4 � <br /> � Emergency Generetor > 30 kw � LP/Natural Gas-ANNUAL Sale ��--I � t� �' <br /> L <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL � • <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers �, <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ O ❑� � Standpipes (Sprinkler Sys) <br /> a Fire Alartn Installation � Torch Roofing/Tar Kettle . �"� ` � (- m � <br /> � Fire Pumps � Waste Tire Storage ANNUAL ��� f��t«ctY'� <br /> � Fire Works I � / <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> , _ . , .. .. q>:r a:5::a"'v`.� a.:b::.,. <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N Fee Current 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: µ � <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 NoGce of Commencement is required (Mechanical work over $5000) <br /> Supply Mro (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />