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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> ��..� ���.-.,�. , �,..,��.�-.:Y��:::_.��< .,K �-. �- a . � .,-,-». :-�-��;�, . <br /> Owner's Name � �• �C Ovmer's Phone Number � � � <br /> Owner's Address •Sr,3 �T q�� �� V N <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> �.��������� . �� _ <br /> Job Address r^� C Lot# � <br /> Sub Division Paroel# <br /> �.. <br /> a Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> aEmergency Generator<30 kw � lP/Natural Gas-Installation <br /> aEmergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> aFire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAI <br /> � emi � er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum � /�j� �� <br /> Fire Alarm � ❑ ❑ � � Sparklers l �t <br /> Hood Cleaning �L'� ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh Roofing/Tar Kettle /Q �� <br /> / <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> aFuel Tanks <br /> Q Other: <br /> .. �:.�;,>_��w�.q,r <br /> Contractor Company � " q C cJ�� <br /> Signature � Registered Y/N Fee Cu ent Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 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 Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ,t+kwt�e;r.a�`:«C���4 , _ _ _ _ ' .. . . __.._ 'r,n:..�vc.s«n� ; �'_:�. ...� _ as . -��. _ _..,...g ;ws.:_:�a <br /> Directions: <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 submittal date. Parcel#-obtained from Property Tax Notice(http:!/appraiser.pascogov.com) <br />