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813-780-0020 Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> �Jate Received Phone Contact for Permit � C� �� <br /> Owner's Name ZL - Owner's Phone Number � 3 �� �/�' <br /> Owner's Address / L L, <br /> Fee Simple Titleholder Name TiUeholder Phone Number � ��� <br /> Fee Simple Titleholder Address <br /> Job Address j �. �, ��/� S �� <br /> Lot # <br /> Sub Division Parcel # �1 � Z�Q � - p � � � _ �/b <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 � LPlNatural Gas-Installation <br /> � Emergency Generetor > 30 kw � LP/Naturat Gas-ANNUAL Sale n <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL �� I 7 3� <br /> �y em� �n er 1 <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ O ❑� a Sprinkler System Installations <br /> Hood Suppression � ❑ O ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Instaliation � 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: ;QF' , ,�^�sio�ll SYsrE'�"'� <br /> � � � - � , : . _ .<•. _ , . . <br /> . , . <_ . a . , ,. .. >. .. .. <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 /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER � Company �- <br /> Signature ' Registered ^ N Fee Current / N <br /> Address p =7� License # —� <br /> Directions:. . . . .�..,. ., ro. �. ... .> .� .. �,_ , , , CJz .. �. �.Q��rSc� <br /> Fill out application completely <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with ovmer) <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 />