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8a3780-OD2D City ofZephyrhills�Fire� FaX-a�saao-oozi <br /> Perrnit Application <br /> Date Received - Phone Contact for Permit <br /> Owners Name �S Owners Phone Number �13, Ia2 • �J`�� <br /> Owners Address ���, n, �' � r � 2 <br /> Fee Simple Tttleholder Name TiUeholder Phone Number � �� � <br /> Fee Simple Titleholder Address <br /> Job Address �(J Z,� + �� Z Lot# � <br /> Sub Division Paroel# <br /> � Bio-Hazard Waste Storege-•ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier il or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LPMatural Gas-installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> ❑ GT�y emi �n er <br /> 5prinkler ❑ ❑ ❑ � � RecreationaiBum ��Q(? " <br /> Fire Alartn � ❑ ❑ �' � � Sparklers 2�,��� <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Instaltations I�U��U'j) '�j <br /> Hood Suppression � p ❑ ❑ � - � Standpipes(SprinklerSys) !(� <br /> a Fire Alarm Installation � Toroh RoofinglTar Kettle � I� `� <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> • Flammable Application-ANNUAL V81Uet10�Of Pf0J2Ct <br /> Fuel Tanks <br /> Q Othe - <br /> Contractor Company ' (Z ' I <br /> Signature ' Registered Y/N ee Curtant Y/N <br /> Address tieense# <br /> ELECTRICIAN Company <br /> Signature ' Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fae 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 /> FII out application completely. <br /> Owner 8 ConVactor sign back of application,notarized(Or,copy of signed conVact with ovmer) <br /> ff over$2500,a Notice of Commencemerrt is required.(Mechanical woric over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Ailow 10-14 days for review after submittal date. Parcel#-obiained from Property Tax Notice(httpJlappraiser.pascogov.com) <br />