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$�s-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br />�ate Received Phone Contact for Pertnit <br />�.�.�-. .- - > . . . . a,�.,�•�a.«xi��,,,�..,�...�a=.„���a�.... .�.ti.=.Ar-�.�•.�-�z.:�-.��.+�-�»�R.�;,�:�.�.:..m�+:.=.._ � . . _ �. _ <br /> lwner's Name Owners Phone Number �/3� Q� I D3� <br /> hnmer's Address 7� � � <br /> ee Simple Titlehoider Name Titleholder Phone Number � � � <br /> ee Simple Titleholder Address <br /> L; � ,. N- -,�.r:-+��.>:�- ;�� �x��°. . <br /> ob Address '��� Lot# � <br /> iub Division Parcel# <br />� ,.'t.'F^`:.`�"4:r x"'.x�tt-�$'y..$e, . . .. .., , _. _ . %.4,.6n9iP-ck"s9'sAa�gq� _ _ . .��'�'6>+tA"$. <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facifity)ANNUAL <br /> � Controlled Bum Q 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 /> �y emi �n er j � � `..,�, ;� <br /> Sprinkler � p�L ❑ ❑ B � Recreational Bum f ��� <br /> 1 =- <br /> Fire Alarm � � ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installati <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � � <br /> � Fire Alarm installation � Torch Roofing/Tar Kettle <br /> QFire Pumps a Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammabie Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other• <br />� �- � , .��-��.�.� y:����; �=.::� :�,-�����;:� . , <br /> Contractor , J Company <br /> Signature k� Regisiered Y/N Fee Current 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 �icense# <br />➢ <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:l/appraiser.pascogov.com) <br />