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b13-io�-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application �� � <br /> late Received / Phone Contact for Pertnit �( � <br />..�.� :..w .r�.�,��.:,�, ..� �+�i���,��,�n�s��a <br /> Nvner's Name Owner's Phone Number C� �� �� <br /> Tnrner's Address 79/b l� <br /> ee Simple Titleholder Name Titleholder Phone Number C� �� � <br /> ee Simple Titleholder Address <br /> _ tl�F`�..'S.t' _ <br />���,_'r".-.«!r�L�« <br /> ob Address � /l Lot# C� <br /> iub Division Parcel# <br />�::�n�._�r.w.^.�°- . _ _ . . _ ac-�ssv . ,. _ � <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent � � <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier ii or RQ Facifity)ANNU/� � <br /> � Controlled Bum � Hood Installation W Q <br /> � Emergency Generator<30 kw � LP/Natural Gas-Instaltation W � <br /> Pp a <br /> aEmergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale � Q <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL a � <br /> �y emi �n er 't x � <br /> Sprinkler � ❑ ❑ ❑ B � Recreational Bum ,�/ .�G�v � � �� <br /> z �,N <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers � <br /> a � <br /> Hood Cleaning � ❑ � ❑ � Sprinkler System Installations A <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) w �" <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle � W 3 <br /> � Fire Pumps � Waste Tire Storage ANNUAL � � � '"ti�' <br /> aFire Works `� � � �� <br /> � Flammable Application-ANNUAL -� Valuation of Project <br /> � Fuel Tanks <br /> Other: �C{,tG,� � c � w <br /> E _�.� � � �. ����- �� � �.�.���.��.t . n�-. <br /> Contractor Company <br /> 5ignature �L Registered Y/N Fee C�urrent Y/N <br /> Address License# <br /> ELECTRICIAN Company <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 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(http:/lappraiser.pascogov.com) <br />