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s�3aso-oo2o Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> _ - Permit Application <br /> Date Received � – \ Z Phone Contact for Pertnit � � � <br /> Owner's Name Z-L�� �L "' �Z ��l�l�G�\ Owners Phone Number � � � <br /> Owner's Address '�J�`,S �T� S � Z-'���N4' � ��--� � <br /> Fee Simple Titieholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> Job Address � - C �� ,�`"� �l' Lot# � <br /> Sub Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct Q 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 � LP/Natural Gas-ANNUAL Sale �— <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> � emi �n er <br /> Sprinkler � '� ❑ ❑ � Recreational Bum /� <br /> Fire Alartn ❑ ❑ ❑ � � Sparklers �>�� <br /> / <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations �. <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable ApplicaUon-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other. <br /> Contractor Company 1 Zy'" � 1 `- 1� ����1 N.. <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 'h+lp'r �� License# i Z[�'7 <br /> ELECTRICIAN Company <br /> Signature I 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 /> MECHANICA 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 application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with ovmer) <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 />