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sis-�so-oe2o City of Zephyrhills Fire <br /> Fax-813-780-0021 <br /> ` Permit Application <br /> Date Received w �--� � � <br /> - Phone Contact for Permit 3 � r� <br /> C <br /> Owner's Name i `� <br /> Owner's Phone Number �(,� �l.i ��� <br /> Owner's Address � <br /> � �1SS��9 I ►'� '�_ _ ��+ � �-� C(,��• �,ti.. �p�� <br /> =ee Simple Titleholder Name � �� � <br /> Titieholder Phone Number <br /> �ee Simple Titleholder Address <br /> Job Address � � � - <br /> � � �3� C� <br /> Sub Division Lo?# <br /> Parcel# <br /> �� Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier il or RQ Facility)ANNUAL <br /> Comm Exhaust Kitchen Nood/Duct � <br /> � Hood Installation <br /> Controlled Bum � <br /> � LP/Natural Gas-Instaliation <br /> Emergency Generator<30 kw � <br /> (--� LP/Natural Gas-ANNUAL Sale <br /> L_� Emergency Generator>30 kw � <br /> � Places of Assembly-ANNUAL <br /> Fire Protection Maintenance-qNNUAL a <br /> Recreational Burn <br /> L.J emi �nT er <br /> Sprinkler � � ❑ <br /> ❑ Sparklers �� m,_� <br /> Fire Alarm � C � � ❑ ))) ��/��/ ,(�j(`'J, <br /> Sprinkler System Installations � U <br /> Hood Cleaning ❑ p � � � ❑ <br /> ❑ Standpipes(Sprinkier Sys) <br /> Hood Suppression p � � � � <br /> � Torch Roofing/Tar Kettle <br /> Fire Alarm Installation a <br /> � Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> � Fire Works <br /> � Flammable Application-qNNUAL <br /> � Fuel Tanks Valuation of Project <br /> QOther: <br /> Contractor <br /> ,• <br /> Signature Company <br /> �,Q v Registered N Fee Current /N <br /> Address rU p w <br /> r"�- License# � <br /> ELECTRICIAN <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# � <br /> PLUMBER <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> MECHANICAL License# <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER <br /> Signature Company <br /> Registered Y/N Fee Current Y 1 N <br /> Address <br />�irections: - <br /> License# � <br /> Fill out application completely. <br /> Owner 8 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 for review after submittal date. Parcel#-obtained from Property Tax Notice htt //a <br /> ( p: ppraiser.pascogov.com) <br />