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s�s-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received �--� Phone Contact for Permit C� �� � <br /> Owner's Name Q �//� Owner's Phone Number gQ � �Q3 <br /> Owner's Address o����/yj� ,��/�, �� q .a' <br /> Fee Simple Titleholder Name Titleholder Phone Number C� � � <br /> Fee Simple Titleholder Address <br /> L�� <br /> A � - ��, .t'�'i s 7<-� z:- <br /> JobAddress � n �C��� ���p � ��f � Lot# � <br /> Sub Division Parcel# <br /> ... -,— - ,. .i . .. ;m. � ,£, .;•.�.-. ,w��: , u�� ., �� -a�� ..��.. ,;�s�: <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent � <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> ry emi �n er <br /> Sprinkler � ❑ ❑ ❑ B � Recreational Bum �'���U <br /> Fire Alarm � ❑ p ❑ �� � Sparklers <br /> Hood Cleaning `bC I `❑ ffi ❑ � � Sprinkler System Installations <br /> ��... 11. <br /> Hood Suppression ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn InsTallation � Torch Roofing/Tar 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 /> .� e.r�7.. . • , , �..,Y.�..pr _',,�,�'a . ,.f <br /> � y <br /> Contractor ' . Company <br /> Signature Registered 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 /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> Directions: - "' <br /> Fill out application completely <br /> Owner&Contractor 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(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Properiy Tax Notice(http://appraiser.pascogov.com) <br />