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si�-�Qo-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> )ate Received � Phone Contact for Pertnit <br /> � � �« ;»�,. <br /> Tnmer's Name (�� � Owner's Phone Number � � � <br /> Tnmer's Address �� J l (i �C L �( <br /> �ee Simple Titleholder Name Titleholder Phone Number � � � <br /> �ee Simple Titleholder Address <br /> a. < � ;,�,+ws���.. <br /> ,tif:�� <br /> iob Address S '�""Z r 'Lot# � <br /> iub Division Parcel# <br /> _ : �„aas�,.��.ra:-.�,�.��_:,.. _. . .�w _ w.— _. ,-.�e�.,� .� t� ��_ �s�;� . . .. .- - <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw Q LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> y emi n er <br /> Sprinkler ❑ �❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ Sparklers <br /> � � <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> aFire Alarm Installation � Torch Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> a Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br />, - -.xA��aP.L.�5�:x,y.akkx:�k':c�.'�6:.,-.;.Y��R�3+��@ _°:.R-,;y� . ��;���$rR'.Zdt-:�'°:q3Ti�retr'�"^�q, �z±,:..,.a.:k.z�4:_:A.r :Cti`�&�:'-�..k�:.r�°.�P.iF. R`&ti..&`.7° -,?bk?k�: _ . ..�,C <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER <br /> Company <br /> 5ignature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL Company <br /> 5ignature Registered Y/N Fee CuRent Y/N <br /> Address License# <br />�THER <br /> Company <br /> 3ignature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />�irections: <br /> Fill out application 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(Mechanical work over$5000) <br /> Supply lwo(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:!lappraiser.pascogov.com) <br />