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s�s-�8o-oozo City of Zephyrhills Fire �ax-813-780-0021 <br /> , • Permit Application <br /> Date Received � Phone Contact for Permit �'( 3 �D( 1 �� Q <br /> Owner's Name � G � ( ` � S Owner's Phone Number C—� � � <br /> Owner's Address e�b '� � (� f �0.�. /7�Y ` j f �— <br /> Fee Simple Titleholder Name�� Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> Job Address Lot# � <br /> Sub Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RCl Facility)ANNUAL <br /> � Controlled Burn � 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 a Places of Assembly-ANNUAL <br /> � emi � t er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum J� � �s�Z <br /> �Li" <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers "�� � <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations ��� �'�� <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) ����� <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> Fire Pumps 2 � Waste Tire Storage ANNUAL <br /> � Fire Works ��i1p �``) <br /> � Flammable Application-ANNUAL i I/ �� � . Q Q D, �(� Valuation of Project <br /> � Fuel Tanks � � <br /> Q Other: <br /> Contractor /� Company �a��l�� S ' L.� 0 � � �� J <br /> Signature (/ Registered Y/N Fee Current Y/N <br /> Address License# O O O �2 7 <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Cunent 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 CuRent Y/N <br /> Address License# <br /> Directio�s: <br /> Fill out application completely <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> ff 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 />