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sisaeo-oozo Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit � �S 83� <br /> Owner's Name Owner's Phone Number �� �V3 Q�Z <br /> Z9 �A �. �" A � <br /> Owner's Address � � �� <br /> Fee Simpie Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address <br /> �� 1..� � � --{"�—,— Lot# � <br /> Sub Division <br /> Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or R�Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LPINatural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural GasANNUAL Sale <br /> �x� Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL <br /> tif•� y emi n er � � � <br /> � ��� <br /> Sprinkler � ❑ ❑ � � Recreational Bum � ( 3 <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 /> aFuel Tanks <br /> Q Other <br /> Contractor �_ � Company a�1 � T �.le S <br /> Signature Registered Y!N Fee Current Y/N <br /> Address � 'ZZ � �c.. a r �� 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 Curcent Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Curtent Y/N <br /> Address License# <br /> Directions: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contrad 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 after submittal date. P2rcel#-obtained from Property Tax Notice(http:!/appraiser.pascoaov.com) <br />