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a� s�so-oo2o City of Zephyrhills Fire Fax-ai �-�ao-oo2� <br /> Permit Application <br /> Date Rewiw::d ` �`� � Phone Contact for Pertnit � 3 1 t 7� �C� <br /> . �: <br /> Owners Name Owners Phone Number ��� C� <br /> Owners Address <br /> Fee Simple Titleholder Name Titleholder Phone Number ���� <br /> Fee Simple Titleholder Address <br /> Job Address ��� �/`'�' ,i'�t!'C/�'+'e— e � /'�r�'� l'�� � 3 ��� Lot # � <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Siorage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct Q Hazardous Mate�al (Tier II or RQ Faciliry) ANNUAL <br /> a Controlled Bum Q Hood Installation _ <br /> a Emergency Generator < 30 kw a LP/Natural Gas-Installation <br /> a Emergency Generator > 30 kw � LPlNatural Gas-ANNUAL Sal +. <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNU L 1� <br /> �y emi �n er / � � � <br /> Sprinkler � ❑ ❑ ❑ � a RecreaUonal Bum <br /> Fire Alarm � ❑ O ❑� a Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � t ❑ X O� a Standpipes (Sp�nkler Sys) �� <br /> � Fire Alartn Installation Q Toroh RoofingfTar Kettle ,)y �� � <br /> � Fire Pumps � Waste Tire Storage ANNUAL l/" � <br /> � Fire Worics � <br /> � Flammable Application- ANNUAL Valuation of Projec <br /> a Fuel Tanks <br /> Q Other: <br /> Contractor �' Company }�Yj G - /-1 - �. � /:Yl.c,.s� <br /> Signature Registered Y/ N Fee CuRent Y/ N <br /> Address y?�/ .l�iG �-4rr �4'" - 'T � License# � �y�3�� �dc�r�.��f <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Cument Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee CuRent Y/ N . <br /> Address License # <br /> �THER Company <br /> Sig�ature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, �ota�zed (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 NoGce (httpJ/appraiser.pascogov.com) <br /> /�1�� S�c" ,�.� �'s�.3 � ��/- �r9�� <br />