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813-780-OQ20 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received �Z – ` — Phone Contact for Permit � � � <br /> Owner's Name 7'� C Z e h r i .S �3� /' G C./ /f C�/ <br /> Owner's Phone Number ��� (O O ( b ! <br /> Owner's Address �� 6 ��t l� � 1 U <br /> Fee Simple Titleholder Name Titleholder Phone Number �� �� �-1 <br /> Fee Simple Titleholder Address <br /> Job Address �� <br /> Lot# <br /> Sub Division Parcel# <br /> . . . .�, , � , .�,�; � Fumigation Ten�. .�, , .�. .. . ._ ., , �,... „ <br /> � Bio-Hazard Waste Stora e-ANNUAL t <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 /> �y emi �n er ❑ <br /> Sprinkler � ❑ ❑ � Recreational Bum �c^�. ��� <br /> Fire Alarm ❑ ❑ ❑ � � Sparklers � <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ � � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation a Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> aFlammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor r ^�' Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address p� R�� U� <br /> 36 D �icense# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> 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 /> 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(http:llappraiser.pascogov.com) <br />