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813-780-0020 Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Pertnit S13 � �J� Qi50 <br /> Owner's Name ec7 L�L, Owner's Phone Number �/� '� � <br /> Owner's Address Z,9 C� ` ^ A 1 <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> Job Address Z,U (_l� R � �L, Lot# �� <br /> �J <br /> Sub Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL Q Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn a 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 /> t y emi �n er <br /> Sprinkler � ❑ O �� � Recreational Bum „ /�� <br /> � �s,. <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sysj <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL r Valuation of Project <br /> Fuel Tanks <br /> Q Other� <br /> Contractor Company �` ��� `dilS_y�C <br /> Signature Registered Y/W Fee Current Y/N <br /> Address — b �/ r` License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Curtent Y/N <br /> Address <br /> License# <br /> P LU M BE R Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> �icense# <br /> OTHER <br /> Company —� <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> Directions. <br /> Fill out appl�cation compietely <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(Mechanicai work over$5000) <br /> Supply two(2)sets of drawings with applicable documentatio� <br /> Allow 10-14 days for review after submittal date Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />