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a�saso-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br />�ate Received � Phone Contact for Pertnit M1 <br /> _, , . . e<..._,�„-. _ ... �. . .r ,. .�.. . •x���r...�.,.,.. , ..... e <br />�wner's Name � �/' ��r� Owner's Phone Number C� � � <br />�wne�'s Address � ! ,J V V � L � � � � c�j�'Y��� � <br /> Fee Simple Titleholder Name Titleholder Phone Number C� � [� <br /> Fee Simple Titleholder Address A <br /> %aaY�w.�.i .:'.a`°<��w+,A1.L'3:"F.�'-Pai�.�iY4"BT.�`+:Y9��diii��`^''.'%.'a�•"$'�'PC°Y�°�"'.�n°J,�:°#'.,9f'Y'd?9d+.�3t",h.���?'�. - ���i.;4:+�.4..�^:W.�..y.. . . .°�' :w'�L# <br /> Job Address Lot# '��� <br /> Sub Division Paroel# <br /> �:°. .._�,..,,M� <br /> . ,. .,._ � ,�k.� .� -. .� _, e , , � . , -. <br /> k .�. sf F"y- , r. �' .. �s. ..� _' i � ` .. . ,.-p.�... � F r_ . ..�.. 'n <br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw a LP/Natural Gas-Installation <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 �� � � � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm 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 />� �:-�.�.._ . ; ,: , � .7t.,.k;_y_�:.,:��:�;�-...�:.n���� �-�.:n �:.,.,,�����y;�, :,..w_.,.,a.,;�-,:�:���.-�.��»�����._��,.��,���,� <br /> Contractor Company _ <br /> Signature Registered Y/N Fee C.urrent Y/N <br /> Address --`� License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee C:urrent Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/I� Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee C:urrent Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee(:urrent Y/N <br /> Address License# <br /> a <br /> Directions: <br /> Fill out application completely <br /> Owner 8 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 Property Tax Notice(http://appraiser.pascogov.com) <br />