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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received � Pho�e Contact for Pertnit <br /> ♦ ..a . x .. ", - , '��at� ..� 'w a ra� e -.o ...- a . .-.. . : s .-� [ i o�ma,t� �@41c%.�rqy+�_ ..y e. r.Y. aw'�vs - . . . . <br /> Owner's Name � Ovmer's Phone Number ��� <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> ss�^ <br /> t_ �� ... = °_-.��^��"�rrr��'' I�J <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> k3 -.�-�:r ,�'M��,m� ,. - - . . s�:� ,_ _ . . <br /> � Bio-Hazard Waste Storage - ANNUAL Q Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Burn � Hood Installation � \ �� <br /> � Emergency Generator < 30 kw � LP/Nalural 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 c �������� <br /> Sprinkler � � ❑ ❑ � Recreational Bum <br /> v� <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers C <br /> � e c�---`.s�.�; � � <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) � <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle � �' —`�� �.J <br /> � Fire Pumps � Waste Tire Storage ANNUAL �/ r�� � <br /> � ' <br /> Fire Works / <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> p- e� .� N°.,r�t �a _#�" . :t . _ . _ . �. _ . �78RM:-w?� _ <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N Fce 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 Y/ N Fee Current Y/ N <br /> Address License # <br /> s <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 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 />