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a�a-�so;oo2o City of Zephyrhills Fire <br /> . Fax-813-780-0021 <br /> Permit Application <br /> Date Recewed �/ /� t3/'/� Phone Contact for Permit 9�/ �i S�Q' �f 73s"' <br /> Owner's Name ZC � LiC �(,�/t ' � Owner's Phone Number �� C� �� <br /> Owner's Address 3���`j � �.-�/ �/L c� GGs �'�� 3�� 7 G- <br /> Fee Simple Titleholder Name Titleholder Phone Number ��� �� <br /> Fee Simple Titleholder Address <br /> Job Address � <br /> Lot # <br /> Sub Division <br /> Parcel # <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 Instal�ation <br /> � Emergency Generator < 30 kw a LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> t y emi �n t er �y � <br /> Sprinkler '� ❑ ❑ B � Recreational Burn f / <br /> Fire Alarm � ❑ ❑ ❑ �i <br /> C � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ C� � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofinglfar Kettie <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL <br /> � Valuation of Project <br /> Fuel Tanks <br /> Q Other <br /> Contractor <br /> Signature Company �y� <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> ELECTRICIAN <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICAL <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> 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 rivo (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 />