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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received , ` . �� Phone Contact for Permit �� �. <br /> Owner's Name � (�G"N GI�%� Owner's Phone Number � � � <br /> Owner's Address 7 �/ e /� / 3�`"7� <br /> Fee Simple Titleholder Name Titlehoider Phone Number � � <br /> Fee Simple Titleholder Address <br /> : , < w,� �,.�. .,.. �,_�� _. �< <�,��.,, r ._-� v�>., � �.r- �^t�:h��.. <br /> �- ,.�,;;•, a.. .< � �� <br /> Job Address � � �� Lot# � <br /> Sub Division Parcel# <br /> e , ,. ,:_ , � . � s._� � � s,ff._ -„�,. � - �< � ..� ... .. ;_ .� � xx�. , <br /> aBio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a 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 t er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ pO ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation l � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor Company <br /> Signature I� �.S�C"� Registered Y/N Fee Current Y/N <br /> Address / pq 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 Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 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 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 worlc 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 />