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s�s-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received • a� • � Phone Contact for Permit 1 3 � w S�� <br /> � . � r�'•,f�u . x <br /> Owner's Name ` Owner's Phone Number � 5 �� V �� 1 7 <br /> Owner's Address Ol 0 � (�-�C � � ` "Q � � �Q � � � Q �� <br /> Fee Simple Titleholder Name ��c� � Titleholder Phone Number �Q �� �' �1" '1� �/ <br /> Fee Simple Titleholder Address �( <br /> _> �- , . <br /> Job Address ( a `� 1 `S � �� � � l � I S � • 3 � �' Lot # � <br /> Sub Division Parcel # <br /> s°�r .F �F ..v��-�°-:=..�t x� <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 Gaslnstallation ( � <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale I��' 7 <br /> � � <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n t er <br /> Sprinkler � ❑ � ❑ � � Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � O ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ O ❑� � Standpipes (Spnnkler 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 /> Q other <br /> � , ,��x., :, as.: «,=e;r� � , . . .,., , . <br /> �s<.� =.�:, x�xr,��•=_��rs,�.s.� °�:� <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> EIECTRICIAN Company <br /> Signature Registered Y/ N Fee Current �( / N <br /> Address License # <br /> PLUMBER Company _� <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> M EC HA N ICAL 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:!lappraiser pascogov.com) <br />