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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> �ate Received y �,3^� � Phone Contact for Pertnit �� �-1 �� <br /> � <br /> Mmers Name � wf7 :,�S ./�ti ( a JvIA' Owner's Phone Number �� 3 7 1� C'/�3 <br /> Nvners Address ��! 1 nn Rr � v4(f��.d � 3�� y �( <br /> ee Simple Titleholder Name Titleholder Phone Number � � � <br /> ee Simple TiUeholder Address <br /> ob Address ✓ j ��� � '� Z a � /►/h�lf -�� �.3�41,Z Lot# � <br /> ub Divisian Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> aControlled 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 a Placas of Assembly-ANNUAL <br /> �y emi � er <br /> Sprinkler � O ❑ ❑ � � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ,� ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � p ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofinglfar 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 /> :onhactor Company G � /�e,pf�.,,i^c w <br /> a��i, <br /> �ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> :LECTRICIAN Company <br /> �ignature � Registered Y/N Fee Curcent Y/N <br /> Address License# <br /> 'LUMBER Company <br /> �ignature Ragistered Y/N Fee Current Y/N <br /> Address License# <br /> �ECHANICA Company <br /> �ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> )THER Company <br /> ;ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> �irections: <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 raquired(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 />