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s�saso-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received " Phone Contact for Permit ��� � <br /> � � � �7 <br /> Owner's Name °'� I�' Owner's Phone Number � <br /> Owner's Address �� c� L �L � - ( t� � �� � r�'l � 1 � � "1 � '� <br /> Fee Simple Titleholder Name Titleholder Phone Number �� �� <br /> Fee Simple Titleholder Address <br /> Job Address " � � � .�)� {� � { �. I � � 9 � Lot # � <br /> Sub Division rcel # <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 a LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> try emi �n t er �I J ��� <br /> Sprinkler � ❑ ❑ ❑ B � Recreational Burn 1 � <br /> Fire Alarm � � � � � � Sparklers <br /> Hood Cleaning � ❑ ❑ 0� � Sprinkler System Installations <br /> Hood Suppression � ❑ � � � � Standpipes (Spnnkier Sys) <br /> � Fire Alarm Installation a Torch RoofinglTar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL �� 1�� L> � Valuation of Project <br /> � Fuel Tanks <br /> Q Other <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <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 '� '�tt� � ""C1L� t�I L <br /> Signature Registered // N Fee Current / N <br /> Address j��' l ! � '�5 License# ' <br /> Directions: <br /> Fill out application completely <br /> Owner 8 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 />