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8J3-780-0020 City of Zephyrhills Fire <br /> Fax-813-780-0021 <br /> � Permit Application <br /> M1ate Received ' _ � - <br /> - <-� x... „ Phone Contact for Pertnit <br /> .��.,«�:.�-r�„�,�.�+�.,��:._,.�� --,�=-..-..;�.�.r:.�.���$«.�„•�:�,.. <br /> hvner's Name C /�/�- l,� b � # <br /> Owners Phone Number �� �� � �� <br /> hvner's Address ` v�s � G�-��, � L v'�, <br /> ee Simple Titleholder Name Titleholder Phone Number � �� �� <br /> �ee Simple Titleholder Address �-J <br /> �LC ;, "$�3•, ' _ <br /> �ob Address - �� �� <br /> � Lot# <br /> iub Division <br /> �. ,:��. �.- Paroel# <br /> aBio-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 � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � <br /> ❑ rly emi � er ❑ � � C���/, <br /> Sprinkler � 7 <br /> � � � Recreational Bum <br /> Fire Alarm � ❑ ❑ p Sparklers <br /> � � ❑ �..._....___._...�.. <br /> Hood Cleaning O ❑ ❑ C] � Sprinkler System Installations <br /> Hood Suppression � ❑ � � � ❑ �sr � ���- <br /> Standpipes(Sprinkler Sys) c� /';�� � ///ttt _ , J <br /> � Fire Alarm Installation � �+��� ,r�: �� <br /> � Torch RoofinglTar Kettle ! ��,�! /`�"� � <br /> Fire Pumps � Waste Tire Storage ANNUAL �../� <br /> � Fire Works ____.,� ' <br /> � Flammable Application-ANNUAL <br /> � Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br />��nx , .. ,� <br /> ' �:� <br /> ��. <br />;ontractor � <br /> iignature / ` Company pl� r/�C� L � �� <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />:LECTRICIAN <br /> ignature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> LUMBER <br /> ignature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ECHANICAL <br /> gnature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> fHER <br />�nature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />•ections: <br /> Fill out application completely <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 drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice htt //a <br /> ( p: ppraiser.pascogov.com) <br />