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813-780-0020 City of Zephyrhills Fire Fax-813-780.0021 <br /> Permit Application <br /> Date Received 9�(� "� Phone Contact for Pertnit �� � <br /> Owners Name Owners Phone Number �� � <br /> Owner's Address <br /> Fee Simple Titleholder Name TiUeholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> �, .:t,3'.r,.;.-g,r.xaiv:"::+�4` . .-y.x� %.0'`"L'::9f�°�.✓; <'R< � °' , <br /> ,., � <br /> o.�Aac►�ss ( !�/1�.� �ot # <br /> �_.. - <br /> Sub Division Parcel # <br /> ' , . k .. ,. .. 53" .. �.,. -§:: :.. .,. . <. ...a 'n 1 . _. . . <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 � lPlNatural Gas-Installation � i� 2/ <br /> � Emergency Generator> 30 kw � lP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � O ❑ ❑ � Recreational Bum <br /> Fire Alartn � O ❑ ❑ � � Sparklers <br /> Hood Cleaning � � ❑ ❑� a Sprinkler System Installations <br /> Hood Suppression � � ❑ ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alartn 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 Other: / z U � <br /> Contractor Company e ,� <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature I 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 /> 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 application completely <br /> Owner 8 Contractor sign back of application, notarized (Or, copy of signed contrect 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 PropeRy Tax Notice (http:lJappraiser.pascogov.com} <br />