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' � � s�saeo-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received �—� Phone Contact for Permit � �S �3d <br /> Owner's Name <br /> � 2 �, Owner's Phone Number � Z.� 1�l]_J <br /> Owner's Address <br /> Z.9 �A L '' �' A 1 <br /> Fee Simple Titleholder Name Titleholder Phone Number � �� �� <br /> Fee Simple Titleholder Address <br /> � �L' ----------- Lot_#_----�----- <br /> Job Address � �--�— ---- <br /> Sub Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gaslnstallation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale ���...,e,��(j1�s <br /> � � �'1 <br /> Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> �� em� � er ❑ ;, 3[ �� <br /> i� _ <br /> Sprinkler O � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning a ❑ ❑ O � � Sprinkler System Installations <br /> Hood Suppression � � ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofinglfar 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 /> ConVactor Company � •a � <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 3Z`Z � License# <br /> ELECTRICIAN Company <br /> Signature <br /> Registered Y!N Fee Current Y/N <br /> Address License# <br /> P LU M BER Company <br /> Signature Registered Y/N Fee Current Y!N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Curcent 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&Contrador sign back of application,notarized(Or,copy oi signed contract with owner) <br /> If over$2500,a Notice oi 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:!/appraiser.pascoqov.com) <br />