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sis-�ao-oozo Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date FY�ceived �'" �� Phone Contact for Permit �� r�� 1 y 7 7"� �laD <br /> Owner's Name � �('1� Owner's Phone Number � 1! LL41.J �l � � <br /> Owner's Address � � V � (� , ,� � 3 � I � <br /> Fee Simple Titleholder Name Titieholder Phone Number �� � <br /> Fee Simpie Titleholder Address <br /> Job Address �� I l Y . � � � � Lot # � <br /> Sub Division Parcei # � ' � � ' - (� <br /> � Bio-Hazard Waste Storage - ANNUAL � 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/Natural Gas-Installation Z/� <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 /> Sprinkler � ❑ ❑ ❑ B � Recreational Burn / <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers b � � �/t�( <br /> �, �,.. . <br /> Nood Cleaning � ❑ ❑ ❑ � � Spnnkler System Installations � �(/�.J <br /> Lp � <br /> Hood Suppress�on � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) �7" � ��� � <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettie <br /> � 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 `r' r� C � n <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address y Q (, G( � �] License # <br /> ( <br /> E�ECTRICIAN 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 <br /> License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <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 />