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3�a-�ao-oo20 �� � L � City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> �ate Received � I � _ Phone Contact for Permit � �� � <br /> ^--^��-s <br /> �wner's Name � 3 �� � � Owners Phone Number �� � �`o�3 �p j,(�1 Z <br /> ►wner's Address �� �' s'{" Z..P 7 l � .-� 3 <br /> ee Simple Titleholder Name Titleholder Phone Number C� C� �� <br /> ee Simple Titleholder Address <br /> ob Address ( `�� '� �'h �j{'" �-e 'J�t.�r�l� ( �S 7� ( 3 3 S�Z Lot# �� <br /> ub Division Paroel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw Q LPJNatural Gas-Instaliation <br /> � Emergency Generator>30 kw � LP/I�atu es�14N IU—Sa�e � <br /> Fire Protection Maintenance-ANNUAL aces of Assembly-ANNUAL � (� � <br /> ❑� emi � er / � <br /> Sprinkler 0 O ❑ ecreational Bum ��� <br /> Fire Alartn � O ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Instailations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn Installation � Toroh RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> :ontractor � Company 0. o�-�f�CC.v <br /> ,ignature Registered /N Fee Cur►ent /N S <br /> Address 'Z'� �+� �. Z � License# <br /> :LECTRICIAN <br /> Company <br /> �ignature I Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> 'LUMBER <br /> Company <br /> �ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> �ECHANICAL Company <br /> �ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> 1THER Company <br /> �ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> iirections: <br /> Fill out application completely <br /> Owner&Contrector sig�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 />