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� <br /> �� 1� '3 h�' _7r1 � <br /> �isaao-oo2o City of Zephyrhills Fire � Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit � �� `� p� . ���"'� <br /> Owners Name � � Owner's Phone Number ��f�� ,�j� ��� <br /> Owner'sAddress (J W • k.r C-h �'�,. ( �(, ! '� p � <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> Job Address � � ` Q —1 �� � �� �• `� h r h 1 (�S 3�� Lot# � <br /> SubDivision Parcel# -�Z �Z�� (��a" lJV j �t.r'"� �� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> aControlled Bum Q Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL �laces of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum 2� <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers � �� <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> � <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> aFire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuet Tanks <br /> Q Other: <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 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 Current Y/N <br /> Address License# <br /> OTHER �n, �Q Company <br /> Signature W�r v � � Registered Y/N Fee Current Y/N <br /> Address License# <br /> Directions: <br /> Fili 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 /> �-t��; ��,�.� I'd � � �,�, r�-+- <br /> 5 3 3� � ��r�t'-c f <br /> Z2�1-�y r h ► ►1 S � �t.. <br /> 33 S�Z <br />