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� �- �{. �rp��'�S 813-780-0020 City of Z:ephyrhills Fire Fax-813-780-0021 �- PermitApplication � �� .Q� Date Received Phone Contact for Permit � �� Owner's Name } � � � F� � �� Owner's Phone Number � � � Owner's Address Fee Simple Titleholder Name � Titleholder Phone Number � � � Fee Simple Titleholder Address Job Address t O � h `I '� �O Lot# � Sub Division 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 r y emi �n er Sprinkler � ❑ ❑ ❑ B � Recreational Burn Fire Alarm � ❑ ❑ ❑ � � Sparklers Hood Cleaning � ❑ ❑ ❑ C] Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ C] � Standpipes(Sprinkler Sys) � Fire Alarm Instatlation a Torch Roofing/Tar Kettle a Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Fiammable Application-ANNUAL Valuation of Project � Fuel Tanks Q Other� Contractor Company Signature Registered Y/N Fee Current Y/N Address 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 /�Q eC / Signature Registered Y/N Fee Current Y!N Address License# Directions. ��n�jJ � 3�s 3 � Fill out application completely r� � v� Owner&Contractor sign back of application,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 applicabie documentation Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http.//appraiser.pascogov.com)