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sisaao-oo2o City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Rec�ved Phone Contact for Permit � � � Owner's Name Owner's Phone Number � � � Owner's Address q, � � Fee Simple Titleholder Name Titleholder Phone Number � � � Fee Simple Titleholder Address Job Address Lot# � Sub Division Parcel# � Bio-Hazard W aste Storage-ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL � Controlled Burn � Hood Installation � Emergency Generator<30 kw � LP/Natural Gas-Installation � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � em� � er Sprinkler � ❑ ❑ ❑ B � Recreational Bum Fire Alarm � ❑ ❑ ❑ � � Sparklers Hood Cleaning � �d ❑ ❑ � � Sprinkler System Instailations / ��O �, Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � � Fire Alarm Installation � Torch Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application-ANNUAL Valuation of Project � Fuel Tanks Q Other: Contractor --'""�-- Company (r �' Signature Registered Y/N Fee Current Y/N Address + Q� License# ELECTRICIAN Company Signature Registered Y/N Fee Current Y/N Address License# PLUMBER Company Signature Registered Y/N Fee Curre�t Y/N Address License# MECHANICAL Company Signature Registered Y/N Fee Current Y/N Address License# OTHER Company Signature Registered Y/N Fee Current Y/N Address License# . ...,.. . ... ., .. Di rections: Fill out application completely. Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) If over$2500,a Notice of Commencement is required(Mechanical work over$5000) Supply two(2)sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)