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s�s-�so-oozo City of Zephyrhills Fire ��{3�l � Fax-813-780-0021 <br /> Permit Application �T� <br /> Date Received Phone Contact for Permit �� �!�.1 U'� <br /> �o r�`dc► �oS ���. � � 0 0 <br /> Owner's Name Owner's Phone Number <br /> Owner's Address 70 0 �!1 l I V� � /� I� 11�b Y� �3(7� ' <br /> Fee Simple Titleholder Name �" � Titleholder Phone Number C� � � <br /> Fee Simple Titleholder Address <br /> Job Address !��G C7`� �� (�1 r�t , xc',�hrr/j 1��s 3a�y I Lot# � <br /> Sub Division Parcel# ^ <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material(Tier II or RQ Far,ility)ANNUAL <br /> � Controlled Burn � 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 t er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Burn <br /> Fire Alarm � ❑ O ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Oo Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> —� <br /> Contractor Company ►1 ti CI'S i��'� $ /7 G <br /> Signature � Registered /N Fee Current �$/N <br /> Address 7� L License# 7 (Jdd � <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# -1 <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> DirecUons' <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:/lappraiser.pascogov com) <br />