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813-780,002o City of Zephyrhills Fire Fax-813-780-0021 <br /> � Permit Application <br /> Date Received ���—� Phone Contact for Permit � U � � �� <br /> Owner's Name � �.",� e� 1/(��� Owner's Phone Number �a�7 �� � S�� <br /> Owner's Address r��e�[ ��IrP � 1-G ft� �'' �L � v�� <br /> Fee Simple Titleholder Name Titleholder Phone Number C� � � <br /> Fee Simple Titleholder Address <br /> Job Address � �+ �(G� � ' h, r' j 1 ,�Q,.., � 5 �� 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)ANNUAL <br /> � Controlled Burn � Hood Installation <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 �n er <br /> Sprinkler � ❑ ❑ ❑ � � I�ecreational Burn <br /> Fire Alarm � ❑ ❑ I� � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ O � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammabie Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other <br /> Contractor Company �/� c'Gc, <br /> Signature Registered N Fee Curre t /N <br /> Address r< �SQ � 7� License# <br /> ELECTRICIAN Compapy <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 /> Fill out applica6on completely <br /> Owner 8�Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mecf�nical 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 />