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s� s-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received � Phone Contact for Permit _��� �� <br /> Owner's Name hone Number � �� �� <br /> Owners Address <br /> Fee Simple Titleholder Name Titleholder Phone Number �� �� <br /> Fee Simple Titleholder Address <br /> _ .. - ` < - . ,> w _ F _ . - .. - .. ,. - <br /> Job Address � A Lot # � <br /> Sub Division Parcel # — Q — — O <br /> �.. ,:.. �. . •:.,:. �_:.., . . �.-. . -� . _. � ,. . c . .,, ,. � . . .. .w. .. . . �_ ... < <br /> r . . ,:. : .:. -. <br /> ,.. . -, <br /> , .. _; .. :... .�.... . �. :- a�a :_- .__.. ... 9 ..�:.. . . .. _..... -.... <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumi ation 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 Generetor> 30 kw � LP/Natural Gas-ANNUAL Sale �,. / <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL � -�! I� � i <br /> ��� <br /> r y emi n er � <br /> 5prinkler O ❑ � � � Recreational Bum <br /> i ( <br /> Fire Alarm ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System installations <br /> Hood Suppression � ❑ ❑ O� � Standpipes (Sprinkier Sys) <br /> a Fire Alarm Installation � Torch RoofingfTar Kettle <br /> � Fire Pumps � Waste Tire Storege ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> � Other: <br /> �. ._. >_.. �. . .. �.�_...._.... .___.. <br /> Contractor Company <br /> Signature Registered N Fee Curcent 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 <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ,.; ,.. , ,. <br /> -, .. ..._ <br /> .. �.. :.. _,. _..�... ,.:. _. .. _..�..._ ,: .�� ._..._:..�:.�_.:_.�,,.: _. �.._:_.,,�...._.�... _<_. _.: ._ .:_,�. : :_..._: _.. -. <br /> ..._ .. .. <br /> irections: <br /> .. ._.>...._.._.... ._� _..M ��. _. w� <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 $50D0) <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 />