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� ai s-�eo-oozo � / �� Ciry of Zephyrhills Fire Fax-813-780-0021 <br /> �l� � Permit Application <br /> Date Received Phone Contact for Permit �=-i=� �`�-J �-ail�=� <br /> Owner's Name -J Owners Phone Number �� L.L� <br /> Owner's Address � � <br /> Fee Simple Titleholder Name Titleholder Phone Number � � �� <br /> Fee Simple Titleholder Address <br /> .� .:-.,.. .t ,�. �: . .. 'r<. <br /> t -�er,"5�:.. °i: <br /> Job Address � � (V 2 � - �� <br /> Lot# <br /> Sub Division G 4� � �' Parcel# <br /> , , ;,�; �*;k�t:s • . ,, .. - . . � . �, ,� . . , , � � . <br /> �5=� ���,. ,. . •ss< <br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LPlNatural Gas-Installation <br /> I`t Emeroency Generator>30 kw � I_PlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ � ❑ � � Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning �� ❑ ❑ � ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation �•` Torch RoofinglTar Kettle <br /> � Fire Pumps )/L/I �� Waste Tire Storage ANNUAL <br /> � Fire Works }L-{7 � <br /> � FlammableApplication-ANNUAL % � Valuation of Project <br /> � Fuel Tanks <br /> Other <br /> y; o ^�� ;.k = _ - �.3: - <br /> �s':, . . .,i�s, �. <.. <br /> Contracto 1 Company <br /> Signature Registered Y/N Fee Current 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 Curreni 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 /> 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 />