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s�s-�so-oo2o Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> r <br /> ate Received � Phone Contact for Permit �Z �o�� r S�� <br /> wner's Name ,.A 2— L..4 r-a C � 2 � � S Owners Phone Number ��i � j �V <br /> wner's Address .�g Z? � l���'l.- �!� <br /> 3e Simple Titleholder Name TiUeholder Phone Number C� C� � <br /> ae Simple Titleholder Address <br />>b Address Lot# � <br />�b Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier il or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System installations <br /> Hood Suppression � ❑ � O � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL r---1 Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> mtractor (� � Company !�� �- rcb C-C^�O <br /> gnature ��u��"f"L 'C�rl.o1Z-C..�\0 I'�.) , Registered Y N Fee Current Y N <br /> Address 7 j ?j��-/ License# <br />_ECTRICIAN Company <br /> gnature � Registered Y/N Fee Current Y/N <br /> Address License# <br />_UMBER <br /> Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br />=CHANICAL <br /> Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> fHER <br /> Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> rections: <br /> Fill out application completely <br /> Ovmer&Contractor sign back of apptication,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement 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:!/appraiser.pascogov.com) <br />