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sis-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received 7 /Z ZD/J Phone Contact for Permit ��j/� (�, S d Lj �3 Owner's Name �t1 F� mt(��[i4 � �L/t � Owner's Phone Number p�,3 7/,s' /$�/j Owner's Address �� C1'ALL /sLc• �C � • 33S � Fee Simple Titleholder Name Titleholder Phone Number C� C� � Fee Simple Titleholder Address �-� .J Job Address Lot # C� Sub Division Parcel # � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL a Controlled Burn � Hood Instal�ation � Emergency Generator � 30 kw � LP/Natural Gas-Installation � Emergency Generator > 30 kw � lP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL ❑ tr y emi � t er ❑ Sprinkier ❑ ❑ ❑ Recreational Burn Fire Alarm � ❑ p �' � ❑ Sparkfers Hood Cleaning � ❑ ❑ ❑�� Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) � Fire Alarm Installation � Torch Roofingffar Kettie � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application- ANNUAL � � Valuation of Project Fuel Tanks Q Other� Contractor Company /� ,�� Signature Registered Y/ Fee Current Y/ N Address License # ELECTRICIAN � Company Signature Registered Y/ N Fee Current Y/ N Address License # PLUMBER Company Signature Registered Y/ N Fee Current Y/ N Address License # MECHANICAL Company Signature Registered Y/ N Fee Current Y/ N Address License # OTHER Company Signature Registered Y/ N Fee Current Y/ N Address License # Directions: Fill out application completely Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10-14 days for review after submittai date. Parcel #- obtained from Pro e Tax Notice htt //a P rtY ( p. ppraiser pascogov com)