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, a�s-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> PeRnit Application <br /> Oate Received ���� Phone Contact for Pertnit U��� <br /> Owner's Name ��— � —[ Owners Phone Number �[� �j�'�Z <br /> OwnersAddress ],/�� v�C.��� � (��� �� �'��j'j <br /> Fee Simple Titleholder Name TiUeholder Phone Number � ��� <br /> Fee Simple Titleholder Address <br /> � - ,tt�-?rr�::�.: :.�>• �� . - .. -- _ <br /> �?:`'3: ^'sx t <br /> Job Address �,� �� L..L '�.� �� <br /> Lot # <br /> Sub Division Paroel # - <br /> ;�:, ,w , � ., ,>, �.. ., . , <br /> ., _, . ,... .., � �; .�:�a. ..;r�.,. - _ <br /> � BiaHazard Waste Storage -ANNUAL � Fumigation Tent Yo- `'( P' . <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> a Controlled Bum � Hood Instailation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> � r y emi �n er <br /> ry <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑�� g Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � SWndpipes (SprinklerSys) <br /> � Fire Alarm Installation � Torch Rooflng/Tar Kettle <br /> a Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL �--� Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor ` Company 4 y e,� . ' � � <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER <br /> 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 /> Directions: ' , <br /> Fill out application completely <br /> Owner & Contrector 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://appreiser.pascogov.com) <br />