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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received ` (o- �{ •-l� Phone Contact for Pertnit 8� �� � <br /> Ownels Name Coc r•�S� Owners Phone Number �l � �4� <br /> Owner'sAddress g SS �?�« �Jd � .�3 S'I � <br /> Fee Simple Titleholder Name TiUeholder Phone Number ��� � <br /> Fee Simple Titleholder Address <br /> ' i'F...}z..:. E , - ' g'- <br /> Job Address .f �� ^p Lot # � <br /> Sub Division Paroel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Faciliry) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw � LPlNatural Gas-ANNUAL Sale <br /> /� Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y em� � er d/ <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum � � � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers �y � v <br /> Hood Geaning � ❑ ❑ ❑ � � Sprinkler System Installations ` � I <br /> Hood Suppression � ❑ f�( ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storege ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL �pQ � Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor Company ; /ti : � / /�'► � <br /> Signature � Registered Y/ N ee Current Y/ N <br /> Address p D � �� ,� ,3 License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PIUMBER 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: <br /> Fill out appiication completely <br /> Owner & Contractor sign back of applicaUon, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical woric over $5000) <br /> Supply Mro (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 />