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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 /> ^ � . --_-� � � ��� <br />�vner's Name IV���-� S p� � Owners Phone Number <br /> / q� ,, p � � <br />�vner's Address !p l� l �i� � <br />�e Simple Titleholder Name Titleholder Phone Number � � � <br /> ee Simple Titleholder Address <br /> _ _ _ _ , . • .fi:7_ ' -4" _ '7.'-.' " ' ' <br />�b Address Lot# � <br /> ub Division Parcel# <br /> , -_ _ ' „.�^y,., M... ,,..��- : � �. .- �_ �.�,.������- _,-a�, ��g,�• _, � , a <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 a LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> r y emi �n er <br /> Sprinkier � O ❑ ❑ � � Recreational Bum <br /> Fire Alartn � � ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations <br /> Hood Suppression � � ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh Roofing/Tar Kerile <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> QFuel Tanks <br /> Q Other: <br />- - .� _ _ _ - .. ,,,,- . .,_ ,..�..,�: . . . _ . , • - - . --, ,.. x��:. _ P.��. ,� �.,. <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 /> ignature Registered Y/N Fee Curtent Y/N <br /> Address License# <br /> THER Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> irections: <br /> Fill out application completely <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(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicabie documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained irom Property Tax Notice(http://appraiser.pascogov.com) <br />