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s�aaao-oo2o Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> � Perrnit Application <br /> Date Received ,�-' w�� Phone Contact for Pertnit ��✓`Z :� 3 o+Q <br /> Ovmer's Name ,i. �� y � Owner's Phone Number � � � l� <br /> Owners Address v o" �'` ��« � s <br /> Fee Simple Titleholder Name � Titleholder Phone Number �� <br /> Fee Simple Titleholder Address <br /> Job Address (�7'�'0� v z �L l ! � � ���" Lot # � <br /> Sub Division Parcel # <br /> � B' azard 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/Naturel Gas-Installation <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 <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar 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 Company j ?` <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 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: � -"f • �� . ¢ <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 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:llappraiser.pascogov.com) <br />