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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received � ( � Phone Contact for Pertnit �� � <br /> �,.. s. _..T—�. <br /> wner's Name �Q ( 'f' }-F� -e ,� (� Owner's Phone Number � � � <br /> wner's Address <br /> se Simple Titleholder Name Titleholder Phone Number C� � �� <br /> �e Simple Titleholder Address <br /> - � , ._E�..�- .<_��.:� �. - - ...,a„ ,.�~•�»,�:;,,��..,�.� - <br /> �b Address �I�� �,/�l.L L J . Lot# � <br /> ub Division Parcel# <br /> - - — � •¢- ..-^� ., ,-_ , . .. „ .,w..,� „ -,..-.,.... r. . ... -- -° „, �e. ,¢;^�,_ ,_.e�.�.a�^��aw:� s.r,�us�r=vs�'a,;� �ar.,�, z � > ,. <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LPlNatural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Naturat Gas-ANNUAL Sale <br /> aFire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alarm � ❑ ❑ � Sparklers <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ O ❑ � � 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 /> � Fuel Tanks <br /> Q Other: <br /> — -- -- - � - - ... - .,._ .. _ ���:�-- �. r _ . .. . <br /> .� _ �:,:�t. . s�,::F.��s - ..... .�k�:T��,.- . r;�a <br /> . . =,�.,:;. ,�. <br /> ontractor /� y� Company �. �� ¢ ,�� <br /> ignature � 0' • V ��(�G.� '1'� Registered Y/N Fee Current Y/ <br /> Address License# <br /> LECTRICIAN <br /> Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> LUMBER <br /> Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> IECHANICAL Company � <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> THER <br /> Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address license# <br /> irections. <br /> Fill out application completely <br /> Owner 8 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 after submittal date Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />