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813-780-00� �j� City of Zephyrhills Fire Fax-813-780-0021 <br /> � Permit�plication <br /> �ate Received �' �� ��/�? � f �� Phone Contact for Pertnit g�,3 .��f� 9'S � <br /> �wner's Name �� J��L-Q �v�V�T� Owners Phone Number � �3 -��S 9 3-�� <br /> Mrner's Address ���r �O/� ��3� � ��7 ��- ��� �7 <br /> ee Simple Tideholder Name Titleholder Phone Number � � � <br /> ee Simple Titleholder Address <br /> ob Address !�/�L� //� �(�� �'v�/ �%C� C�' /1--� �� �, Lat# � <br /> ub Division Paroel# <br /> � BiaHazard Waste Storage-ANNUAL � FumigaUon Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generetor<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembiy-ANNUAL = <br /> � em� � er I� <br /> f � ��,�� <br /> Sprinkler � ❑ ❑ ❑ a Recreational Bum <br /> f <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers � <br /> Hood Cleaning � ❑ �' ❑ � � Sprinkler System Insta ' ns `� _ <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> aFire Works <br /> � Flammable Application-ANNUAL r--� Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> :ontractor `'L� �'"' CompanY , s .s� <br /> ,ignature 2 Registered Y/N Fee Current Y/N <br /> Address License# <br /> :LECTRICIAN Company <br /> �ignature I 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 /> 9ECHANICAL Company <br /> �ignature Registered Y/N Fee Current 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 applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:/lappraiser.pascogov.com) <br />