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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Appiication <br /> �aie Received � ��� ( � I Phone Contact for Pertnit � � � <br /> Mmers Name <br /> ' ��j � s Owner's Phone Number � 5 � l, ` <br /> Mrner's Address � �- � I I � J � <br /> ee Simple Tideholder Name Titleholder Phone Number � � � <br /> ee Simple Titleholder Address <br /> ob Address C � � � L'`_ 1 �-�� ^ � Lot# � <br /> ub Division Paroel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAI <br /> � Controlled Bum � Hood Installation <br /> aEmergency Generator<30 kw a LP/Natural Gas-Installation <br /> � Emergency Generetor>30 kw LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> � emi � er <br /> Sprinkler � ❑ � ❑ Q RecreaUonai Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Spariclers <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations <br /> Hood Suppression � � ❑ ❑ � � Standpipes(Sprinkier Sys) <br /> � Fire Alartn Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> a Flammable Application-ANNUAL 1 Valua6on of Project <br /> � Fuel Tanks <br /> Q Other: <br /> �,._... � �,�✓r..�� <br /> :ontractor Company ° I(''��`'X� ��J <br /> ,ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> :LECTRICIAN Company <br /> �ignature � Registered Y/N Fee Current Y/N <br /> Address License# <br /> 'LUMBER Company <br /> ;ignature Registered Y/N Fee CurreM Y/N <br /> Address License# <br /> 1ECHANICA 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 conVact with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with appiicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:/lappraiser.pascogov.com) <br />