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813-780-0020 City of Zephyrhills Fire <br /> Permit Application Fax-813-780-0021 <br /> �ate Received <br /> Phone Contact for Pertnit � � (�'�'� <br /> ,,v�x-r l___�_._J <br /> �wner's Name � (,�Q �.���� � �� <br /> r� Owners Phone Number �� <br /> wvner's Address �-7 9 G�L� �j 'z�,SQ/� �f�L�s G� <br /> ,33 c�/ <br /> ee Simple Titleholder Name �� � � <br /> ee Simple TiUeholder Address Titleholder Phone Number <br /> ob Address <br /> ub Division <br /> Lot# C] <br /> Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � <br /> � Fumigation Tent <br /> Comm 6chaust Kitchen Hood/Duct <br /> � � Flazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Bum <br /> � Hood Installatfon <br /> Emergency Generator<30 kw � <br /> � Emergency Generetor>30 kw �P/Natural Gas-Installation <br /> � Fire Protection Maintenance-ANNUAL � �P�Natural Gas-ANNUAL Sale <br /> Places of Assembly-ANNUAL <br /> ❑�y emi nT er <br /> Sprinkler � � � ❑ <br /> ❑ Recreational Bum <br /> Fire Alartn ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � � � � r—, � <br /> ❑ I.__J Sprinkler System Installations <br /> Hood Suppression p � � I--"I ❑ <br /> � L__� Standpipes(Sprinkler Sys) <br /> Fire Alartn Installation � <br /> � Torch Roofing/Tar Kettle <br /> Fire Pumps � <br /> � Waste Tire Storage ANNUAL <br /> Fire Works <br /> � Flammable Application-ANNUAL <br /> � Fuel Tanks Valuation of Project <br /> Q Other: <br />:ontractor <br />�ignature ��_ — Company <br /> Address Registered Y/N Fee Current Y/N <br />:LECTRICIAN License# � <br />,ignature Company <br /> Address Registered Y/IV Fee Current Y/N <br />'LUMBER License# �— <br />�ignature Company <br /> Address <br /> Registered Y/N Fee Current Y/N <br /> fECHANICAL <br /> License# r�— <br /> ignature Company <br /> Address <br /> Registered Y/N Fee Current Y/N <br /> THER <br /> License# <br /> gnature Compa�y <br /> Addrass <br /> Registered Y/N Fee Current Y/N <br /> rections: License# <br /> Fill out application completely <br /> Owner&Contrector 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(p)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice h //a raiser.pascogov.com) <br /> � ttP� PP <br />