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s�saso-oo2o City of Zephyrhills Fire Fax-813-790-0021 <br /> Permit Application <br /> ate Received �—� Phone Contact for Pertnit � y(�� � <br /> wner's Name , —}- c.,E.h�� Owners Phone Number ��� [-1-� , � , �.7="J <br /> wner's Address <br /> �' � ''� 33 f <br /> :e Simple Titleholder Name '� -- Titleholder Phone Number � �� � <br /> :e Simple Titleholder Address <br /> �b Address 3 S� z2 h o�(-s � �3 S�� Lot tF � <br /> �b Division Parcel# <br /> _ _ , _. <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material�er 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 /> �y emi �n r I ��� <br /> Sprinkler � ❑ � ❑ � � Recreational Bum �! <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � O ❑ � � a Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofinglfar Kettle <br /> � Fire Pumps a Waste Tire Storage ANNUAL <br /> � Fire Works <br /> a Flammable Application-ANNUAL - S'r�-- Valuation of Project <br /> � Fuel Tanks <br /> Other. n A� � ,� <br /> mtractor Lr_c..0 Company <br /> gnature 'f�J.�^^"— �1 dW`T(�(, /nJ I��c� �� Registered Y/N Fee Current Y/N <br /> Address License# <br /> _ECTRICIAN Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> _UMBER Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> =CHANICAL Company <br /> �nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> fHER Company <br /> �nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> rections: <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 appiicable documentation <br /> Allow 10-14 days for review after submittal date. Paroel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />