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siaa8aoo2o City ofZephyrhillsFire�-':'_. Fax-813-780.0021 <br /> � � Permit App(icafion <br /> Date Received • Phone Contact•for Pertnit � <br /> Owner's Name p�- �/'1 Owner's Phone Number � � � <br /> Owner's Address /y��� G�'// �1� <br /> Fee SimpleTitleholder Name Titleholder Phone Number C� � � <br /> Fee Simple Titieholder Address <br /> Job Address Lot# � <br /> 5ub Division Paroei# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Matertal(Tier II or RQ Facflity)ANNUAL <br /> � Controlled Bum � Hood installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Instailation <br /> � Emergency Generator>30 kw � LP/Naturel Gas-ANNUAL Safe <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly ANNUAL �/,3�ji �� <br /> �y emi �n er � <br /> 5prinkler � ❑ p ❑ � � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � p ❑ ❑ � Sprinkler System Installatlons <br /> Hood Suppression � ❑ � O � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn Instaliation , � Toroh Roofing/Tar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Appiication-ANiVUAL � Valuation of Project <br /> FueiTanks <br /> ' Q Other: <br /> Contractor , � Company � <br /> Signature ` Ragistered N Fee Curre Y/N <br /> Address s L License# <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 <br /> License# <br /> OTHER Company <br /> Signature Registered Y/N Fee CuRent Y/N <br /> Address <br /> License# <br /> Directions: <br /> Fill out application completely. <br /> Owner&Corrtractor sign 6ack of application,notarized(Or,capy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required.(Mechanical work over$5000) <br /> Supply iwo(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notiae(httpJlapp2iser.pascogov.com) <br />