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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> . � Permit Application <br /> ate Received � � , ,^ Phone Contact for Permit `j�j S�' CT{�� <br /> avners Name �� Owners Phone Number � � �o�'(� <br />�aner's Address �S�/ t7 d l ^ 3S <br /> ee Simple Titleholder Name Titleholder Phone Number �� � � <br /> ee Simple Titleholder Address <br /> - . . ;x r ° �,� .r�a� .,x.. M. <br />�b Address Lot# � <br /> ub Division Parcel# <br /> „��»,�.N-_ . �: �.��,� „ �.»�. ,_�..�.�, .- . <.;,-r ._-.� n �n _��>,��.ax�,�r.�-� �_.._�.., .z�-e* , � , . , <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent _ --.- , <br /> .�---'_.. �. <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Materiai(Tier II or acility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Instal tion ff /� <br /> � �/�'7,•� v <br /> � Emergency Generator>30 kw � LP/Natural Gas-AN AL Sa J / <br /> � Fire Protection Maintenance-ANNUAL Places oi Assembly N <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum -�- <br /> Fire Alarm � � ❑ ❑ � � Sparklers <br /> Hood Cleaning � O � � � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> � Flammabie Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br />__ _ _ _... _ .�__ __ - _c°=,�_ . - ,..�..^r�;,..x�*�sc,aa-t,, �.. : _. "�.. _ .y.... . ,_ k., . Fs�;,. .^r„-<.�...�, a. '°+±,�-.�ris.;r�. <br /> � ,. "r�.+a°,a.,.; :z•b� .,C'°:):' ,�;* <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 Cunent Y/N <br /> Address License# <br /> THER Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address <br /> 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 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:/Jappraiser.pascogov.com) <br />