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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit �� �� <br /> Owners Name Owners Phone Number �}'�3 7/3 77 <br /> Owner's Address ' Z'i'/ � GC � � � � �/� , <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � 1 I <br /> Fee Simple Titleholder Address �—.J <br /> Job Address �� <br /> Lot # <br /> Sub Division <br /> Paroel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � �P/Natural Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Pratection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> ❑ 3fr y emi �n er ❑ <br /> Sprinkie�r ❑ O ❑ Recreational Bum <br /> Fire Alairm � ❑ ❑ ❑ C� � Sparklers <br /> Hood Cleaning � ❑ O ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ �j ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Worics <br /> � Flammable Application- ANNUAL <br /> � Valuation of Project <br /> Fuel Taraks <br /> Q Other: <br /> Contractor <br /> 5ignature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> _LECTRICIAN <br /> L Company <br /> 3ignature Registered Y/ N Fee Current Y/ IV <br /> Address <br /> License # <br /> 'LUMBER <br /> iignature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> AECHANICAL <br /> �ignature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> 1THER <br /> ignature � Company •, ' �� � � , � , <br /> Registered Fee Current (� <br /> Address <br /> License # ��� � <br /> irections: — <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 woric over $5000) <br /> Supply two (2) sets of drewings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />