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s13a8o-oo2o CityofZephyrhillsFi�• ,�„ � �'�` Fax-e�s-�so-oo2� : <br /> . Pertnit Appiicadon :�li I �� <br /> � - <br /> Date Received - Phone Corrtact for Pertnit <br /> Owners Name W P�bcaa Ovvner's Ptro�e Nurt�er .� 7� Z„ ��� <br /> ONmers Address �� � � �� � <br /> Fee Simple Titlehdder Name Titleholder Phone Number r_� � C� <br /> Fee Simp{e "litlehoider Address <br /> . Job Address Lot # � <br /> 5ub Division Par�el # <br /> Q Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> Q Comm Exhaust IGh:hen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Cenerator < 3p kw � LP/Natural Gas-Ir�staliation <br /> � Emergency Gonerator > 30 kw � LPlNatural Gas-ANNUAL Sale <br /> � Fre Protectlon Mairrtenance - ANNUAL � Piaces of Assembly-ANNUAL --- <br /> �y errn � r <br /> SprinMer � ❑ ❑ ❑ Q Recreatiorml Bum <br /> Fre Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Clea�ing O � �� � Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ � � Standpipes (Sprirdde� Sys) <br /> � Fire Alartn Instaila6on � Torch Rooflng/Tar Kettle <br /> Fire Ptunps � Waste Tire Storage ANNUAL <br /> Fire Worlcs <br /> Flammable Ap{�licatlon- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> ther: <br /> Contractor ComPa�Y <br /> � � <br /> S�9"a�B Registered Y/ N Fee current Y/ N <br /> Address '� "— - License # <br /> ELECTRICIA ��� <br /> Signature Registered Y J N Fee Current Y/ N <br /> Address License # <br /> PIUMBER ��� <br /> Sig"et�e Registered Y/ N Fee Cument Y/ N <br /> Address u� # <br /> MECHANICAL ��� <br /> Signature Regiscered Y/ N Fee Current Y/ N <br /> Addaas <br /> u� # <br /> OTHER � <br /> Signature Rey;stered Y/ N Fee Currerrt Y/ N <br /> Address <br /> Licerue # <br /> Direcdons: <br /> Ftli out appiication completely. <br /> Oamer & Contractor sign back of applicatlon, notaraed (Or, copy af signed contract with ow�er) <br /> if over S2s00, a Notice of Commenceme�t Is requi►ed (Mnc:hanical work over $5000) <br /> S�PP�Y � �Z) �� drawings with applicable documentatlon <br /> Ailow 10-�4 days tor review afler submittal date. Paroei #- obtairmd from Property Tax Nodce (hSp•J/appraiser.pascogov.com) <br />