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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> y 0 � 0 <br /> Date Received Phone Contact for Permit � 7 <br /> Owner's Name �,{� W- h� � � Owner's Phone Number � 1?j �7�0 b Ut� Z, <br /> Owner's Address ') �3`j 0�" �j f �¢,,{� <br /> Fee Simple Titleholder Name Titleholder Phone Number ��� <br /> Fee Simple Titleholder Address <br /> Job Address � � / � � Lot # � <br /> Sub Diwsion Parcel # (- Z�o - O� � �'-� i 3`-� p U ci C� � L; <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Burn � Hood Installation <br /> Emergency Generator < 30 kw C� �� ult � LPlNatural Gas-Installation <br /> � Emergency Generator> 30 kw � �,, ��_ � � LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> ry emi � er <br /> Sprinkler � ❑ ❑ ❑ B � Recreational Burn <br /> Fire Alarm � ❑ ❑ C�3' � � Sparklers ` <br /> cil <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations � I �� J�� <br /> / � <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) �( <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> a Fuel Tanks <br /> Q Other� <br /> Contractor , Company � °�6 rJ � L $�u �.iT 5 S T�mS �T•� <br /> Signature Registered Y N Fee Current Y/ N <br /> Address '�, � v . D�c-� �rl q� � w .t#�� Ti�m FL 33 License # FOGDO�i o <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 <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <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 />