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8�3-78U-0020 City of Zephyrhills Fire Fax-813-780-002'I <br /> Permit Appiication <br /> ate Received 3� Z-- Phone Contact for Pertnit � �� C-1 <br /> --� <br /> �nmers Name K Q�'�' ?j��p\ Owners Phone Number �� �� �� <br /> �vners Address 2,� q�, B1vA • <br /> :e Simple Titleholder Name Titleholder Phone Number C� � � <br /> �e Simpte Titleholder Address <br /> �b Address ZZ �Q, ��4 ' �� <br /> Lot# �� <br /> �b Division Paroel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation ` <br /> � Eme enc Generator>30 kw � <br /> r9 Y � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �J / � <br /> _ r y emi n er � ��! � } <br /> Sprinkler j w j� O ❑ � RecreaUonal Bum �' <br /> Fire Alarm �p ❑ �I � � Sparklers �."' <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � p ❑ ❑ � � Standpipes(Sprinkier Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle � �j � !� 5 <br /> � Fire Pum s '` <br /> P � Waste Tire Storage ANNUAL �✓ <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> mtractor Company �Ut1Ciu O - <br /> gnature Registered Y N Fee Current Y/N <br /> Address License# <br />.ECTRICIAN <br /> Company <br />�nature � Registered Y/N Fee Current Y/N <br /> Address License# <br />.UMBER <br /> Company <br /> 3nature Registered Y/N Fee Current Y/N <br /> Address License# <br />=CHANICAL <br /> Company <br /> 3nature Registered Y/N Fee Current Y/N <br /> Address License# <br />(HER <br /> Company <br />�nature Registered Y/N Fee Cument Y/N <br /> Address 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(http:!/appraiser.pascogov.com) <br />