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813-780-0020 City of Zephyrhills Fire <br /> Fax-813-780-0021 <br /> Permit Appfication <br /> �ate Received —� Phone Contact for Permit � �� �� <br /> wmer's Name ;/ — Owners Phone Number �� �j �� <br /> Mmer's Address �,�''� ��.5 � �� <br /> ee Simple Titleholder Name Titl Ider Phone Number � C� � <br /> ee Simple Titleholder Address ��J <br /> ob Address � � l • � � <br /> Lot# <br /> ub Division <br /> Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � 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 /> ❑ 3Fr y emi � er <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ �� � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ �� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � a 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 <br /> � Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> :ontractor , �` � � <br /> �c J�; Company -� � � <br /> ,ignature ��.� _` <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> :LECTRICIAN <br /> ,ignature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> 'LUMBER <br /> ,ignature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />�ECHANICAL <br />�ignature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> 1THER <br />�ignature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> iirections: <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://appraiser.pascogov.com) <br />