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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Receiv��' �� Phone Contact for Permit y� �ts� Q�,3,5 <br /> Owner's Name zG h,2 �CL (/�«�l 1' /�-� /1A� Owner's Phone Number �� � <br /> Owner's Address ��� !� /�/�/� �D� � ry Q/ti �C� �L � 3syp <br /> Fee Simple Titleholder Name Titleholder Phone Number � �� <br /> Fee Simple Titleholder Address <br /> Job Address Lot # � <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) a{VNUAL <br /> � Controlled Burn � Hood Instaliation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> try emi � t er <br /> Sprinkler � ❑ ❑ � � Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers �� / <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkier System Installations �' r <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other <br /> Contractor <br /> Company ��rs ,cinnc'1L <br /> Signature Registered Y J N Fee Current Y/ N <br /> Address <br /> License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> license # <br /> PLUMBER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> Directions: " " <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 reqwred (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 />