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s�saso-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate ReceiveS Phone Contact for Pertnit 3 Z l 3�]? 2„/f,� <br /> wner's Name 7j"�r �K�u.S ��P Owners Phone Number �� � � <br /> wner'sAddress 777 �' /V` I✓�'1"1 � .�.+I�ErJW �G�i( G� l� 6 �jD <br /> 3e Simple Titleholder Name TiUeholder Phone Number � � � <br /> 3e Simple Titleholder Address <br />>b Address L 7 3� � S� Z�/ k l/`�N��� / � Lot# � <br />�b Division Parcel# l�'L-�v ' Z�• �� "07�_ �� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> aControlled Bum a Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generetor>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Piaces of Assembly-ANNUAL <br /> � emi � er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alarm � ❑ ❑ �� � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> aFlammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other. <br />�ntractor / } /fQ � � � Company <br /> gnature �`'��N`�'�+^^ ���SN�-^-ti Registered Y/N Fee Current Y/N <br /> Address License# � �ypOOO 3?/ <br />_ECTRICIAN Company <br /> gnature I Registered Y/N Fee Current Y/N <br /> Address License# <br />_UMBER Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br />_CHANICA Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address License J� <br /> fHER <br /> Company <br /> 3nature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> rections: <br /> Fill out application compietely. <br /> Owner&Contractor sign back of application,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 drewings with applicable docume�tation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />