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s�s-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received Phone Contact for Permit �� Owner's Name r r e,n �� Owner's Phone Number �� Owner's Address � y C� L Fee Simple Titleholder Name Titleholder Phone Number �� Fee Simple Titleholder Address Job Address Lot # �� Sub Dwision Parcel # � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL � Controlled Burn � Hood Installation � Emergency Generator < 30 kw � LP/Natural Gas-Installation � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL ry emi �n er , � �� Spnnkler � ❑ ❑ ❑ B � RecreaUonal Bum ,,,Yy Fire Alarm � ❑ ❑ � � � parklers ,+'� S Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) � Fire Alarm Installation � Torch RoofinglTar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application- ANNUAL Valuation of Project Fuel Tanks � Other� Contractor t �� Company ' ` Signature �� .��JC�� (�i�� 1� Registered Y/ N Fee Current Y/ N Address '}o �1� 'r ,�� License# ELECTRICIAN Company Signature Registered Y/ N Fee Current Y/ N Address License # PLUMBER Company Signature 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 & Contractor sign back of app�ication, 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 drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://2ppraiser.pascogov.com)