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s��-�saoo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received�' �-� Phone Contact for Pertnit �� � <br /> Owner's Name �TZ�9� /f ffLF Owners Phone Number �-� ?/-� OSLO <br /> Owner'sAddress 3�'l°U /�o.+z7�i �v� ,zr � r��� � <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> - � - �:: _ : , � ��z � , . <br /> Job Address Lot # � <br /> Sub Division Parcel # <br /> ; :+ , �. , . . _ ... , .. , . . <m.,. .�. ..r � . <br /> � Bio-Hazard Waste Storage - ANNUAL a 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 � LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw Q LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � Q Sparklers <br /> Hood Cleaning � O �j ❑� � Sprinkler System Installations <br /> Hood Suppression � � � ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation a Toroh Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Q Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> ConVactor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N Fee Curtent 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 c�G+�ir � r E�E�vi/�rne.vT �L�. <br /> Signature Registered N Fee Current Y N <br /> Address License # �i O�� /�p( <br /> Directions: " <br /> Fill out application completely <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract 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 />