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a�s-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received Phone Contact for Permit �� C� r-� L–�LL`7_1 Owner's Name Owner's Phone Number Owner's Address —' � , Fee Simple Titleholder Name Titleholder Phone Number �� Fee Simple Titleholder Address Job Address ' a �' - Lot # � Sub Division Parcel # � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facilily) ANNUAL � Controlled Burn � Hood Installation � Emergency Generator < 30 kw � LPlNatural Gas-Installation � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL ❑ ry emi �n er ❑ Sprinkler ❑ ❑ ❑ Recreational Burn �� Fire Alarm ❑ ❑ �� Sparklers f 1j� Hood Cleaning � ❑ ❑ � � � � Sprinkler System Installations Hood Suppression ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) � Fire Alarm Installation � Torch Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � FlammableApplication-ANNUAL Valuation of Project Fuel Tanks Q Other Contractor Company � Signature Registered Y/ N Fee Current / N Address License # ELECTRICIAN Company Signature Registered Y/ N Fee Current Y/ N Address License # PLUMBER Company Sionature Registered Y/ N Fee Current Y/ N Address License # MECHANICAL Company � Signature Registered Y/ N Fee Current Y/ N Address License # OTHER Company Signature Registered Y/ N Fee Current Y/ N Address License # Directions: Fill out application completely Owner 8 Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawmgs with applicable documentation Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:/lappraiser.pascogov.com)