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813-780-0020 �ity of Zephyrhills Fire �7� Fax-813-780-0021 <br /> Permit Application � <br /> ate Received Phone Contact for Permit l 3 �T � 3 3 3 <br /> iwners Name 1 Q S Dlel���. Owners Phone Number �� C� �� <br /> n�vner's Address S,�(� �'�" S� 2e ph r �� � S � � ,j�j�� <br /> �' � � � <br /> ee Simple Titleholder Name Titleholder Phone Number <br /> ee Simple Titleholder Address ✓--- <br /> �b Address �� <br /> Lot# �� <br /> ub 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 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 � Places of Assembly-ANNUAL <br /> r y emi �n er <br /> Sprinkler � ❑ O ❑ � � Recreational Bum , <br /> Fire Alarm � ❑ ❑ p�� � Sparklers f�/��/A <br /> / / C,� <br /> Hood Cleaning ❑ ❑ ❑ � � Sprinkler System i tallations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprin er Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar K e <br /> � Fire Pumps � Waste Tire Storage ANNU <br /> � Fire Works <br /> a Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> ontractor 1�S t.� — <br /> ignature �� ' �� �7 ' Corp¢any � C � _ <br /> 1 �-z1�✓►1ct l�gistered Y/ ` /N <br /> Address 'S 6 �U w 1 ' Z ✓�1E} L�oaaso�k�'"° y U }� <br /> LECTRICIAN Company <br /> ignature I Registered Y/N Fee Current Y/N <br /> Address License# <br /> LUMBER Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> IECHANICAL Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> iTHER Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br />�irectians: <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 applicabla documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br /> S"3 3 S- �''� ��- <br />