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s�aaso-oozo Ciry of Zephyrhills Fire Fax-a��-�so-oo2� <br /> Permit Application <br /> Date Received S 3/.- / Phone Contact for Permit ��� <br /> Owners Name � ���'J��jt � � � 'Z� Owners Phone Number � �� � <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number �� �� <br /> Fee Simple Titleholder Address �-�-� � <br /> Job Address � �(� � � � ,S � Lot # C� <br /> Sub Division Parcel # <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 a LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw � LPlNatural Gas-ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> � IfTr emi �n er ❑ <br /> Sprinkler ❑ ❑ Recreational Bum /!7 <br /> � r <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers '� / <br /> Hood Cleaning �❑ ❑ p� � Sprinkler System Installatio ��' <br /> Hood Suppression � ❑ ❑ ❑ �� � Standpipes (Sprinkler Sys) �('/� <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle ��� � <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Appfication-ANNUAL Valua6on of Project <br /> � Fuel Tanks <br /> Q Other. <br /> � � < . . . �:�;. . <br /> Contractor <br /> Company <br /> Signature _ Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature � Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER <br /> 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 <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address , License # <br /> Directions: . , . . <. ,. , . . <br /> Fill out application completely <br /> Owner 8 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 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 />