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a�3aao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Pertnit Application <br /> Date Received � Phone Contact for Pertnit ��� <br /> Owner's Name s(,�� � u S Ovmers Phone Number ��� ��� � <br /> Owners Address � �� ° °� � � x � U � Zf> � a �( S - <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> � %� <br /> Job Address � �r�'l/�/ � ^ Lot # � <br /> Sub Division Par�el # <br /> � Bio-Hazard Waste Storege - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facili ANNIJAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installatio �/� <br /> Emergency Generator> 30 kw � LPlNatural Gas-ANNU Sale J � a � <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly- NUAL 9�► 1 � <br /> �y em� �n er �� � <br /> Sprinkler � � ❑ ❑ � � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning �� ❑ ❑� � Sprinkler System installations <br /> Hood Suppression � ❑ ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofingffar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Projeet <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor 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 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 ��ri'7 hrc = r � <br /> Signature Registered N Fee Current N <br /> Address License# C7y/ Q(p <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 (httpJ/appraiser.pascogov.com) <br />