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s�3��ao-oo2o City of.Zephyrhills Fire Fax-813-780-0021 <br /> � . �Permit Application <br /> Date Received ��� l� �� '� Phone Contact for Pertnit � 5'�},s <br /> ����. �- �,..:���,, 3.� <br /> ,��.., ....�.w..���,,�...,,,_� .. <br /> Owner's Name G�7� ,�� J� � Owne�s Phone Number O �3 S ✓� 3.�j � <br /> Owner's Address �- Q.�0/� �3 T�M f�? L 33 6 7� <br /> Fee Simple Titleholder Name Titleholder Phone Number �� �� C] <br /> Fee SimpleTitleholder Address <br /> � .. <br /> Jab Address ,���/UQ� ���� ��s� �(,L ��vQ, Lot# C� <br /> Sub Division Paroel# <br /> �� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent F <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-instaliation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �� <br /> �y emi �n er � � <br /> Sprinkler � ❑ L7 ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ � ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ O ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Fiammable Application-ANNUAL V'aluation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> :.�� <br /> Contrector C��E, i , � CompanY S S <br /> Signature ��� Registered Y/N Fee Current Y/N <br /> Address <br /> 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 <br /> Company <br /> Signature Registered Y/N Fpe Current Y/N <br /> Address <br /> License# <br /> Directions: . <br /> Fill out application completely. <br /> Owner&Contractor sign back of appiication,notarized(Or,copy of signed contract with owner) <br /> if over$2500,a Notice of Commencement is required(Mechanical work over$500D) <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:/lappreiser.pascogov.com) <br />