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si3aao-oo2o City of Zephyrhills �ire F�x-��3-�ao-oo2i <br /> Permit Application <br /> Date Received � �� Phone Contact for Permit L�� � � <br /> Owner's Name Owner's Phone Number � � �� <br /> Owner's Address v C..� � / /� <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � � <br /> Fee Simple Titleholder Address <br /> _ , . .. . , , .. , . <br /> � z. , _. r ,_,_, _ . <br /> Job Address <br /> Lot# � <br /> Sub Division Parcel# <br /> '_.. r c 3r�. .�_. z - <br /> -.. 'i- , • ��•. <br /> , ... .._ • . x �>':,� .� �-� .� ". ,: , ..�.., �:�;:. . ._ � ., �... .. . . . .. ... .. . . . <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAI <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � E ency Generator>30 kw � LP1Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n r <br /> Sprinkler � ❑ ❑ � Recreatio�al Burn <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers � � � v <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm I�stallation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL r--, Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> , >. ; � ,, ... . - -�� . ,. �: . _ <br /> Contractor Company i��Q- �� Q � <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 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 CuRent Y!N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Sig�ature Registered Y/N Fee Current Y/N <br /> Address License# <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> tf 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:/lappraiser.pascogov.com) <br />