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a�s-�8o-002o City of Zephyrhills Fire Fax-813-780-0021 <br /> � " Permit Application <br /> Date Received Phone Contact for Permit � � � <br /> Owner's Name C..� p T 7P I! �, �!✓C Owner's Phone Number � � � <br /> Owner's Address 5335 �� V J �� �1 �� �!J l��^ ✓�.J� � <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> Job Address 37 Q� Ch e' f , � ri.DO � i l s Lot# � <br /> Sub Division Parcel# 03�-a� -a�� G a�b—%UaO��(1��� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> aEmergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale ��cy// <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL / I <br /> tr y emi �n er ��/� � � <br /> Sprinkler a ❑ ❑ � � � Recreational Burn ��� <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other� <br /> Contractor " / Company ife�S�f re � A7S � <br /> Siqnature � Registered /N Fee Current Y/N <br /> Address H � L / �icense# C7S QOp � <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 /> ' � F <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 rivo(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 />