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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received � Phone Contact for Pertnit ��� �e� <br /> � � {�rtj•l/S /n►E. <br /> � � Lz � � � 0 <br /> Owner's Name �� .� �_... k t+' Owner's Phone Number <br /> Owner's Address �p 3 � r�� � tI � <br /> Fee Simple Titleholder Name TiUeholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> Job Address � [ lO � (y �-� ( � � � Lot # � <br /> Sub Division Parcei # ��' ZF�' Z�� UUZU � �6�U� '�UL r <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 � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protecfion Maintenance - ANNUAL � Places of Assembly-ANNUAL o I , ,� <br /> �y emi �n er � v�' <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers �y `��J 3� <br /> �T � / <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ � ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alartn 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 1 L / ' ��� „ CompanY ( t r- /7 c <br /> Signature � � Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company ?' ryt/Q5 L.lSyt[aC1�C �/,Q�:-f,e(Ci9JL CD�-�j' <br /> Signature � Registered Y N Fee Current Y/ N <br /> Address License # G D � Z��j <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 & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical woiic 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 />