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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received � Phone Contact for Permit '� E � <br /> r x �, . _ � _ ..,4 . ..x � , :_. ., . . .�- ,�-.�, . ..,x .a _. .... <br /> Owner's Name \ _ Owner's Phone Number �� � <br /> Owners Address 3 (� ��` S I' �� <br /> Fee Simpfe Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> . ro . �q _ ' `,�'k�-'.w�.':z�;'a. -r�-���* - _ '"ff- :��,r::e#e:° .°v:i3'w-�`"�`�.�.x-uk .s� � �;r�,rseµ.;€?�p"�'�r�� <br /> Job Address Lot # � <br /> Sub Division Parcel # <br /> g �..� .�€tk:^�i,ac.S^.•�JR'1�9�.'_4".',�@'.�; . ,A.�va�,v`.iB:Y`9X.k�`k`t4.'_�+`�'ufa:+i4"��¢r.'^'i .��Kf . 9at�p _ =04'.`-P^ts� '€�)�4'RPSR��".'z�-F*m'- <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 � LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw � lP/Naturel Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er � <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum �` <br /> � lJ <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 othe � <br /> F .- . -,. R#. b.., , �'s.i6, ,.,9 �k :���`".�'-�c'?A-:�a'�� ^k �- � ,. - . w � ,y <br /> . _ �^� �r .. sc °�:ar,.;s��'�€��*�.;,.`:rc�����i=_ _ ,w�s:?s�°». :�-��a���":a�����a' <br /> Contractor Company 1 � <br /> Signature �� Registered Y/ N Fee urrent / 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 <br /> Signature Registered Y/ N Fee CuRent Y/ N <br /> Address License # <br /> i <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 documentatio� <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />