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813-780-0020 City of Zephyrhills Fire Fax-813-780.0021 <br /> Permit Application <br /> : Received q� 2. q��� Phone Contact for Pertnit S/,3 q 6 6 9 <br /> �ers Name j n�� ( ���¢,�' ic.o-,rj pwner's Phone Number �/ 7�2- 77 <br /> iersAddress j) . T Z� �. i � /'l 3J � <br /> Simple Titleholder Name TiUeholder Phone Number C� C� C� <br /> Simple Titleholder Address <br /> Address Q,lti`�` � <br /> Lot # <br /> Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL Q Fumigalion Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazarclous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Instaltation �,- <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sa ��� <br /> ✓� Fire Protection Maintenance -�ltYY�1,t �ff�pv< < � Places of Assembly-ANN L �� <br /> ❑ � emi � er ❑ <br /> 5prinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ C� � Sprinkler System Installations /�� � <br /> Hood Suppression � ❑ �' O �� � Standpipes (Sprinkler Sys) � l � ` <br /> � Fire Alarm Instaliation � Torch Roofing/Tar Kettle � <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> a Fire Works <br /> � Flammable Appiication- ANNUAL <br /> � Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> tractor <br /> iature <br /> Company F'�.� K L <br /> Registered Y/ N ee Current Y/ N <br /> Address p p <br /> � � License # <br /> CTRICIAN � Company <br /> iature � Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MBER <br /> ature Company <br /> Registered Y/ N Fee Cument Y/ N <br /> Address <br /> License # <br /> :HANICAL <br /> ature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> ER <br /> �ture <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # �, <br /> tions: <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 worlc 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 (httpJ/appraiser.pascogov.com) <br />