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813-780-0020 City of Zephyrhills Fire Fax-813-780-002'I <br /> , . Permit Application <br /> ate Received ..,+'`%Z 3— 3 Phone Contact for Pertnit � L��1(� (�,y G <br /> wners Name 1 .e_._e_,� �^ ' rti Owners Phone Number 8 i 7�O ''Z � '7 <br /> yvners Address 7 8 3�j �,�\� �J� y �-4 i l� 33�-(Z.- <br /> �e Simple Titleholder Name Titleholder Phone Number �-1 � � <br /> �e Simple Titleholder Address <br /> �b Address ,scx„w.-�� Lot# � <br /> �b Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material�er II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood InstallaUon <br /> � Emergency Generator<30 kw � LP/Naturel Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-/1NNUAL � <br /> � Fire Protection Maintenance-ANNUAL � Ptaces of Assembly-ANN AL � ! <br /> �y emi � er �� ,� <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers �+ <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkier System installations <br /> Hood Suppression /� p �' ❑ � � Standpipes(Sprinkier 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 /> mtrector ` <br /> — Company - �` Y��d li��-- <br />�nature Registered Y/N Fee Current Y/N <br /> Address .�. /�i p' Q License# <br />.ECTRICIAN Company <br />�nature � Registered Y/N Fee Current Y/N <br /> Address License# <br />.UMBER <br /> Company <br /> 3nature Registered Y/N Fee Current Y/N <br /> Address License# <br />=CHANICA <br /> Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> fHER <br /> Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address License# <br />�ections: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with ovmer) <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 />