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ais-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> • ' Permit Application <br /> ate Received � Phone Contact for Permit <br /> � , . - - �.� � <br /> �wners Name � Owner's Phone Number �� 7'(�Z I 7� <br /> L= <br /> rv�mer's Address � <br /> ee Simple Titleholder Name Titleholder Phone Number �� C� �� <br /> ee Simple Titleholder Address <br /> L�J <br /> � : . - �,- _ <br /> �b Address (�� <br /> Lot# � <br /> L.._ <br /> ub Division Parcel# <br /> _ .,�r., .. ..... _.. ,_ ,a -.a...,ro.rs .xw.. - c,-... ._ .' ' . y.?' t� _� __ -' 'sx ,:;�.a�.,..° r c�.t:F�.ren;p• a:..,'> . <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)A,N�ILAb- <br /> � Controlled Bum � Hood Installation �,�-'"�� <br /> � Emergency Generator<30 kw � LPlNatural Gas-Installation� <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNU ale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly- UAL �� ' <br /> �y emi � er �� � <br /> Sprinkler � ❑ ❑ !4 � � Recreational Bum � <br /> Fire Alarm � O O Q! �� � Sparklers � �� <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installati s` � � <br /> Hood Suppression � ❑ p � �� ❑ , �"""'� <br /> Standpipes(Sprinkler Sys) <br /> a Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> aFire Works <br /> � Flammable Application-ANNUAL <br /> QValuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> ontractor � v -•-, . . -.. _ _ .. � , _ , _. �- . , 4• -- . : . ,�„x; ,, s �.< .. ., . <br /> ignature Company <br /> Regisiered Y/N Fee Current Y/N <br /> Address <br /> License# <br />_ECTRICIAN <br /> gnature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />_UMBER <br /> gnature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address � <br /> License# <br />=CHANICAL <br /> Company <br />�nature ' <br /> Registered Y/N Fee Cunent Y/N <br /> Address <br /> License# <br />�HER <br />�nature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ections: <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 htt //a <br /> � P� ppraiser.pascogov.com) <br />