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p eis-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Dat�e Received � Phone Contact for Permit <br /> .� �,„ ,�.._k , - <br /> ��v,. ,�<.��:.��_� t � . <br /> �,-:.. ., »�,���-��-,�_<�._.c..*.-� . . <br /> Owner's Name S� � Owners Phone Number C] � �� <br /> L� <br /> Ovmers Address <br /> Fee Simple Titleholder Name Titleholder Phone Number C] � � <br /> Fee Simple Titleholder Address <br /> :�:;:��rn"r��:a�-=��-���-:a�a�; <br /> Job Address 7� , ,. j � <br /> i .,��S7Z-- Lot# <br /> Sub Division Parcel# <br /> ��,,.���c.�, . x.,�. <br /> aBio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a 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 /> ❑� emi � er <br /> Sprinkler ❑ ❑ ❑ � � Recreational Burn <br /> Fire Alarm � ❑ ❑ p � � 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 Wo�lcs <br /> � FlammableApplication-ANNUAL Valuation of Project <br /> aFu �nks <br /> Q O er: <br /> x.rn«sr�rnx�.,,.. <br /> Contrector <br /> Company / S/ <br /> Signature '`- Registered /N Fee Current Y/N <br /> Address <br /> 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 License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> �4 License# <br /> Directions: "'��v "" a� ,,��.��a��.��.�. <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 submitta�date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />