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a�s-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received l Gv�� Phone Contact for Permit ��l Y-� D735' . Owner's Name �� LS! `j r � L ' Owner's Phone Number �� Owner's Address �J� � � � K/K-S L 33 � Fee Simple Titleholder Name Titleholder Phone Number �� Fee Simple Titleholder Address Job Address Lot # � Sub Division Parcel # � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL � Controlled Burn � Hood Installation � 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 �n t er Sprinkler � ❑ ❑ � Recreational Burn Fire Alarm � ❑ ❑ ❑ � � Sparklers Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) � Fire Alarm Installation � Torch Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application- ANNUAL Valuation of Project � Fuel Tanks � Other� Contractor Company jst i /� Signature Registered Y/ Fee Current Y/ N Address License # ELECTRICIAN Company Signature I 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 Fdl out application completely Owner & Contractor sign back of apphcation, notanzed (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 submittal date Parcel #- obtained from Property Tax Notice (http //appraiser pascogov com)