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813-780-fJ02(" City of Zephyrhills Fire <br /> Permit Application Fax-813-780-0021 <br /> Date Received ' —j _ � <br /> ` ' � • �,,.�,��;�,,�,�A„j T Phone Contact for Permit <br /> . .�. .,. ,�.., , �-�,�>:., <br /> Owners Name ��L ,��-/C� � � <br /> � Owner's Phone Number � �� <br /> OwnersAddress �j-.�L L /� � V��/ <br /> Fee Simple Titleholder Name � �� �� <br /> Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> �:. �.���w. <br /> Job Address � <br /> Sub Division Lot# <br /> :�.._ , Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � <br /> � Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum <br /> � Hood Installation <br /> Emergency Generator<30 kw � <br /> � LP/Natural Gas-Installation <br /> Emergency Generator>30 kw � <br /> � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL � <br /> � Places of Assembly-ANNUAL <br /> �� emi �nT� er ❑ <br /> � <br /> Sprinkler ❑ ❑ � Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ p � ❑ ) , )(�Z;�� <br /> ❑ Sparklers ��� / T <br /> Hood Cleaning p � � � ❑ <br /> ❑ 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 <br /> � Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> �;.>.��:� . <br /> Contractor <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# �— <br /> ELECTRICIAN <br /> Signature Company <br /> ' Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address _..._ <br /> `'"`'�`'' , . License# <br /> Directions: r->�..;.�_-�„-,��-;_�- e�,r <br /> -� . ._,,�. � .�x^�t.�,s.�c.a-.,arx <br /> Fill out application completely <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contrect 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 htt !/a <br /> ( P: ppraiser.pascogov.com) <br />