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s��-�so-oozo City of Zephyrhills Fire Fax-813-780-0021 <br /> • ' Permit Application <br /> ate Received � Phone Co�tact for Pertnit � � �� <br /> wners Name �r�/� E—lL-i� �S L or7l SC Owners Phone Number � �j '�� � r%U_/.. 1C � <br /> wner's Address (T� 1'[v7 /7(�T'� ST Li,�� <br /> �-?-�-�D N '��-- <br /> ;e Simple Titleholder Name Titleholder Phone Number � � C� <br /> se Simple Titleholder Address <br /> �J <br /> �b Address Lot# � <br /> �b Division Parcel# <br /> � Bio-Hazard Waste Storege-ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood InstallaUon <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 /> ❑[ r y emi � er � <br /> Sprinkler ❑ ❑ ❑ Recreational Bum /%/`�NJ�'� <br /> Fire Alarm � ❑ ❑ „�� � Sparklers � f/ � ` J <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System install tions <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys <br /> � Fire Alartn Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> a Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> her. <br /> mtractor <br /> Company `' �- AO �y� c.��.,-y <br /> gnature Registered Y/N Fee Curtent Y/N <br /> Address '� d ( <br /> License# or,tYlccwtt 4vo�,yoa,tc,�/ <br /> .ECTRICIAN Company <br /> gnature � Registared Y/N Fee Current Y/N <br /> Address License# <br /> _UMBER <br /> Company <br /> gnature Registered Y/N Fee Cur►ent Y/N <br /> Address License# <br /> =CHANICAL Company <br /> �nature Registered Y/N Fee Currant Y/N <br /> Address License# <br /> fHER <br /> Company <br /> 3nature Registered Y/N Fee Cument Y/N <br /> Address License# <br /> rections: <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 far review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />