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s� �-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> . - Permit Application <br /> Date Received -/ - l Phone Contact for Pertnit ��� <br /> Owners Name Zf.J''//�yNi�l 1 j,iJ.�F/�.� Owners Phone Number ��� <br /> Owners Address � 3 3 v � v� � S/ <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> . . , , ^a:�=• .�.:a - •��.��+a ��p2ac�;��v ��. - S: a::t � : . . .. ; s. _ ; r-. .,, , - � • �i�= > �:�t'���: �;? X�*�.a� �': - <br /> y�..�,m' :.*....s� 'z <br /> Job Address Lot # � <br /> Sub Division Parcel # <br /> ° , r* ...8%'�s:���,t�a �, *+1krfi+t;.: .,. , � . .� , t. .. � 'Y.€i ..�is:7c:�:�i'�: "x.?o'r .r�. . ...:, _. ° � ��v� .. <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Mate�al (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Instailation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> � �y emi � er ❑ <br /> Sprinkler ❑ ❑ Recreational Bum <br /> Fire Alarm � ❑ ❑ O � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� a Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps a Waste Tire Storage ANNUAL <br /> Fire Works <br /> � Flammable Application-ANNUAL ValUatiOn of P�ojeCt <br /> � Fuel Tanks <br /> Q Other: <br /> . . � , S. . . .. . . . " , ' ' -. . .,.. .'� . . .3t .. .. . .... .''.?� .. .. . a <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN 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 License # <br /> OTHER Company L <br /> Signature Registered / 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 Property Tax Notice (http://appraiser.pascogov.com) <br />