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813-780-0020 City of Zephyrhills Fire <br /> Permit Application Fax-813-780-0021 <br /> 3te Received <br /> Phone Contact for Pertnit �� 78 p ."�� <br /> ��o�-- <br /> wner's Name �` � � � �� <br /> Owners Phone Number <br /> ovners Address ��33 �Ta\� �V a �,� ,3,�s�� <br /> :e Simple Titleholder Name � �� �� <br /> Titleholder Phone Number L� <br /> ae Simple Titieholder Address <br /> �b Address Q <br /> �b Division <br /> Lot# �� <br /> , . Parcel# <br /> � Bio-Hazard Waste Storege-ANNUAL a � � '" <br /> � Fumigation Tent <br /> Comm Euhaust Kitchen Hood/Duct <br /> � � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Bum <br /> � Hood Instailatfon <br /> Emergency Generator<30 kw a <br /> � LP/Natural Gas-Installation _ <br /> � Emergency Generetor>30 kw a LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL � �`'f' \'� <br /> Places of Assembly-ANNUAL r ` <br /> ❑ _r y emi � er ❑ � <br /> Sprinkler � � � � <br /> ❑ Recreational Bum �� <br /> Fire Alartn O ❑ ❑ � � Sparklers % %� <br /> Hood Cleaning � � ❑ � <br /> � � Sprinkler System Installations / <br /> Hood Suppression � p � yr � � <br /> � �°�! Standpipes(Sprinkler Sys) <br /> Fire Alartn Installation � <br /> � Torch Rooflng/Tar Kettle <br /> Fire Pumps � <br /> � Waste Tire Storage ANNUAL <br /> Fire Works <br /> � Flammable Application-ANNUAL <br /> a Fuel Tanks Valuation of Project <br /> [] Other. <br /> ntractor . _ <br /> nature Company '�'; � �.(� �R� ` <br /> Address o o g$ , , 3 <br /> Registered Y/N Fee Current Y/N <br />:CTRICiAN 6 3 License# <br />�atu►e Company <br /> Address Registered Y/N Fee Current Y/N <br /> IMBER License# �— <br /> iature Company <br /> Add►ess <br /> Registered Y/N Fee Current Y/N <br />:HANICA <br /> License# <br /> ature Company <br /> Address Registered Y/N Fee Current Y/N <br /> ER License# r� <br />�ture Company <br /> Address Registered Y/N Fee Current Y/N <br /> tions: License# <br /> Fill out application completely. <br /> Owner&Contractor sign back ot appiication,notarized(Or,copy of signed contract wlth owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicabie documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice h //a raiser.pascogov.com) <br /> � ttP� PP <br />