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ai s-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> ' Permit Application <br /> ate Received �iwti �� Phone Contact for Pertnit �� � <br />.���•.,:._N_.y�<-. ..:st�.a _ '. +n.s»t+�xs»-�.asK.�,:....�....,.;,.,<.warts-s� _ �s�ws <br /> ovner's Name ��'l�f'eS"F+�re �d3 �O+t f h�Sf IVC�� 31�-�0 Owner's Phone Number C� � �� <br /> wner's Address ��'1� Va(( ��U� <br />�e Simple Titleholder Name Titleholder Phone Number � � � <br /> ee Simple Titleholder Address <br />��.,. „*.,.. .,,� , �� <br />�b Address ��1�I ��1 1 �d Lot# <br /> ub Division Parcel# <br />��.;s•xadlc�:r.ad-: t� , . - . . <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm F�chaust 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 /> � Emergency Generator>30 kw a LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL '� <br /> ❑�r y emi �n er �/? <br /> / <br /> Sprinkler ❑ ❑ ❑ � Recreational Bum ��i-. <br /> l <br /> Fire Alarm � � ❑ ❑ � � Sparklers �� f ;�/ <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installati s '� . <br /> Hood Suppression �' ❑ �" � � � Standpipes(Sprinkler Sys) <br /> aFire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � �Naste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br />�,_;k��;:._��;.,, ,_ �. •�w.. <br /> Contractor � �" Company (e� �P-�' �aA f <br /> Signature r/L'� �JdS����m��� Registered Y/N FeeCurrent 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 Curtent Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Curtent Y/N <br /> Address License# <br /> k <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 afler submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />