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a�3-�so-oo2o City of Zep`�yrhills Fire �ax-813-780-0021 <br /> • Permit Application <br /> Date Received ��/� Phone Contact for Permit �j j I� � ?� C1-.�.�-.� <br /> �. <br /> Owner's Name r�' ( � .. �—^ Owner's Phone Number � � � <br /> Owner's Address �,3 � j� <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 RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LPlNatural Gas-Installation <br /> � mergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNU <br /> �y emi �n er � / j/ <br /> I� �'F <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum � � <br /> Fire Alarm �❑ ❑ � Sparklers <br /> L ._.._. <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Ins ` <br /> Hood Suppression � ❑ ❑ ❑ � � 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 Other: <br /> Contractor �=r'- Y CompanY f /"'` �Lh. <br /> Signature " Registered N Fee Current Y/N <br /> Address � f License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current 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 Current Y/N <br /> Address License# � � <br /> Directions <br /> Fill out application completely. <br /> Owner&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 />