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813-780-0020 City of Zephyrhills Fire Fax-&13-780-0021 <br /> Permit Application <br /> ate Received �� � �� Phone Contact for Permit �� �� � <br /> wner's Name ��/j, �ers Phone Number ! � I ��- 1 a,V'a-- <br /> wner's Address - O u...�� +� �"'`. �L° �y y�� ��'S ��.. 3 �y�r <br /> :e Simple Titleholder Name Titleholder Phone Number C� �� � <br /> :e Simple Titleholder Address <br /> �b Address �J � 1 t.Y��'► ��T"1'L°�i'�"� � h� `� �L, V`��"v�Z Lot# � <br /> �b Division Parcel# <br /> � 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 /> � 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 /> ❑�y emi �n � <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ O ❑ � � 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 Valuation of Project <br /> Fuel Tanks <br /> Q OEher: <br /> �ntractor Company <br /> . ° 12A �,. <br /> gnature Yw 1!'�i�S r Registered Y/N Fee Current Y/N + <br /> Address License# <br /> _ECTRICIAN Company <br /> gnature � Registered Y/N Fee Current Y/N <br /> Address License# <br /> _UMBER Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> =CHANICA Company <br /> �nature Registered Y/N Fee Current Y/N <br /> Address License tk <br /> fHER Company <br /> �nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> rections: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contrect with owner) <br /> If over$2500,a Nolice 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 />