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8't3= �80-0020 Ciry of.Zephyrhills�Fir:e• Fax-s�aasaoozi <br /> Permit Application <br /> Date Received - Phone ContacYfor Pertnit �] Q a� <br /> Owners Name O('� �� �C. Owners Phone Number -� ��. �� <br /> Owner's Address 3 1 � � <br /> Fee Simple Titleholder Name Titlehoider Phone Number ��� � <br /> Fee Simple Titleholder Address <br /> Job Address � � IJ � � Lot# � <br /> Sub Division Paroel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kltchen Hood/Duct � Hazandous Material �er II or RQ Facility) ANNUAL <br /> � Controtled Bum � Hood Instaltatlon <br /> � Emergency Generator < 30 kw � LP/Naturel Gas-Installation <br /> � Emergency Generator > 30 kw � LP/Naturel Gas-ANNUAL 5afe <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly ANNUAL <br /> �y em� �n er 2 � Q <br /> 5prinkler � O O O � Recreational Bum �� f Z s�J U <br /> .� � � <br /> Fire Alartn � ❑ O �, � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � p ❑ ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Toroh Roofingll'ar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> � Othe <br /> ConVactor Company � <br /> Signature Registered Y/ N Fee Curren Y/ N F 3�y�y� <br /> Add�ess 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 <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: <br /> FII out application completely. <br /> Owner 8 Contractor sign back of application, notarized (Or, copy of signed conVact with owner) <br /> If over 52500, a Notice of Commencemerrt 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:/lappraiser_pascogov.com) <br />