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s�sasaoozo City ofZephyrhills'Fir:e�- _. Fax-slsasaoo2� <br /> Permit Application <br /> Date Re�eived — --( - Phone Contact for Pertnit � <br /> n�; . ...�.,�.���;,� <br /> Ovmers Name w �� Owners Phone Number � � � <br /> Owner's Address �� Q e� <br /> Fee SimpleTitleholder Name Titleholder Phone Num6er � C� � <br /> Fee Simple Titleholder Address <br /> L_.�_1 <br /> Job Address �� <br /> Lot# <br /> Sub Division Paroel# <br /> �:�.� <br /> � BiaHazard Waste 5torage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facflity)ANNUAL <br /> Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LPlNatural Gas-Instaliation <br /> Q Emergency Ge�eretor>30 kw � �P/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � �� <br /> �y emi �n er � <br /> 5pnnkler � ❑ ❑ ❑ � � Recreational Bum � I <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ p p <br /> 5prinkler5ystem Instaltations <br /> Hood Suppression � ❑ �� ❑ � Standpipes(Sprinkler Sys) <br /> � Fire Aiarm Installation � Toroh Roofing/Tar Kettle <br /> n Fire Pumps � Waste Tire 5torage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL r Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> a <br /> ofw"�i: <br /> Contractor Company �'(� <br /> 5ignature Ragistered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL Company <br /> 5ignature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER <br /> Company <br /> Signature Registe2d Y/N Fee Current Y/N <br /> Address <br /> . ,., <br /> License# <br /> Directians: � <br /> Fill out application completely. <br /> Owner&Contractor sign back of appfication,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'I D-'14 days for review after submittal date. Paroel#-obtained from Property Tax Notice(httpJ/appraiser.pascogov.com) <br />