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813-780-0020 <br /> City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> � Phone Contact for Permit � � � � <br /> Date Fceceived <br /> Owner's Name LI <br /> , h � h��� � (C�( Owner's Phone Number D I 3 � U� �' <br /> Owner's Address 3 �"r 7 D�% '�e-� �--� �� � <br /> Titleholder Phone Number <br /> Fee Simple Titleholder Name <br /> Fee Simple Titleholder Address <br /> Lot # � <br /> Job Address <br /> Parcel # <br /> Sub Division <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw �jC �� u-�t � � LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL �f �-��"� � � Places of Assembly-ANNUAL �� � <br /> ❑ ry emi �n er ❑ /� <br /> Sprinkler ❑ ❑ ❑ Recreational Burn � � / /,� <br /> � � ❑ /O <br /> Fire Alarm ❑ ❑ Sparklers <br /> Hood Cleaning � � � ❑� � Sprinkler System Installations <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 /> � Fuel Tanks <br /> a Other <br /> Company �l�C'7''�onllC STGGI.c�ST'J S'J' S'►'�/>'�S�' <br /> Contractor � <br /> Signature Registered / N Fee Current Y/ N <br /> Address �//p L` Gt,83 License# r� ddoo�' <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> License # <br /> Address <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> License # <br /> Address <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> 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 />