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a�3-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> � Permit Application <br /> ate Received � � (� '�- Phone Contact for Permit �� 7�.Z !9�/ <br /> � .,. ,.. .w . � , _ .. . _ � .,,.._� � <br />�uvner's Name J E22- �S r' S i a� ��! � ✓�� Owner's Phone Number ��..3 7gd � 'I�� <br /> nnmer's Address rJ 0'7 ��L �rJ GI ' <br /> ee Simple Titleholder Name Titleholder Phone Number � � � <br /> ee Simple Titleholder Address �~/0 �(. ✓o <br /> -- .. . ,_, ..�:.�c :��-� - ° <br />�b Address � <br /> Lot# <br /> ub Division Parcel# <br /> , _ �_ - ., , . , ., ., ,. , ., .. _ . .>, �. ._ . ..�•�.>.�_ :..�.s«,.._ .. :�-t �,,.,.. �. ,_ , � r <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � 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 Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> r y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers t � ' �y�y <br /> r�r� <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations Y � <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storege ANNUAL <br /> aFire Works <br /> � Flammable Application-ANNUAL , Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br />- - r� .. • - �... . . .. , _ <br /> - _ ,��.� _ ., -.r - � . . {:..-KR� - . � ���e . .., �� � <br /> ontractor <br /> Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> LECTRICIAN 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 <br /> License# <br /> IECHANICAL Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> THER <br /> Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> rections: <br /> Fiil 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 /> 5upply 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 />