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ais-�eo-oozo City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Rtceived � �� -� �- l t 1 Phone Contact for Permit �� � <br /> .. ,�--��-^^--��^ - - <br />�wner's Name W�T�-M�7�-� (� ���b Owner's Phone Number � � � <br />�wner's Address <br /> ee Simple Titlehoider Name Titleholder Phone Number � � � <br /> ee Simple Titleholder Address <br /> - .. . .�,p».p... a' -.°.:. ... . . ..... . c -�- ..'4�:s��i3 �i �.u',° ,q�^,5°^_ s`x`y.S`. " '--" ." +'r. <br />�b Address -- W!7�M�L/ °; O�7V V� Py7�i3� �/9 C.0 /.S L J�[ ZL���f�L�` �'�( �1S-� Lot# � <br /> ub Division Parcel# <br /> „ - . -=�aN . _ � r .�_..,._.F..44..� z,.*a_ , - ,,,, -;h.«.. F�.. • r>. . l•_ _ v,. -�.,,_ - k r??d a�.w.7s:w�, v"�°F^R:��9��` "�r-�:r. , .�k.-, . <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 � LP/Natural Gas-installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sa�e <br /> Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> � emi � er <br /> Sprinkler � O ❑ ❑ -f�Y � Recreational Bum <br /> Fire Alarm � ❑ O ❑ � � Sparklers <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> aFire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Wortcs <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> - � __� . .. _. - - - s..�_ • v.� �tiy,:�-:.� ��a .. _. , s- ._ �, � .. .� �,.r:- .,:;.r �.:�-_ .�:,.�.�r, . ::�-fi-,�: �..._ ,. <br /> ontractor ___ Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> LECTRICIAN Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> LUMBER Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> IECHANICAL Company <br /> ig�ature Registered Y/N Fee Current Y/N <br /> Address License# <br /> THER Company <br /> ignature Registered Y/N Fee Curcent 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 worlc 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 />