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a�raaso-oo�o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Reoeived � — �- Phone Contact for Pertnit ��� <br /> . . . .. ... .... . . ....... ... ... . �. . ;�. � , ..f.�. <br /> Owner's Name ' Owners Phone Number �,3 �� <br /> Owner's Address �S " <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> � ,. <. :�.M , � - «..s:a.?x�3<rb`�rr„xx^�;;�:;:�,3�; s* .. �� >.„. ;��`ra; R.�:- �:z���.�'�.::.�. y�E,. . . . <br /> Job Address �S �� Lot # � <br /> Sub Division Paroei # <br /> . ., ,t . . ,>. ..;�•,.....g r.� .>�.a�,�:.,. . 9�».a:=a-�;�,�;_s: .. .. • . . _ .. .E ,,. . ,�.. :�.., :��s�.:�;���a:a �:�: ,. ._-s�:�.., .. � � . <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier il or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> a 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 � Z Z/�_ <br /> �y em� �n er L ~ P � <br /> Sprinkler � ❑ ❑ � � � Recreational Bum <br /> Fire Alartn � ❑ ❑ � � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> FlammableApplication-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> � . - . ,. . r., ....:•*. ... , ,. , . ,. . . . . _ . �s>. ., .. �. , . ... _ - - , . <br /> Contrdctor Company � ' <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Addres 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 /> 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 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 drewings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />