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, <br /> s�s-7so-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received � Phone Contact for Permit � � � <br /> c�_:�_.�--__.�:!--_�..:�__�_ -_.--___.�-._w.._�.__r_�,=_�__�_ - _____-��_-__w_._� _�_--_-°----'-_--_�,___.u._--��_,__�_.,__.r._�-�____..,e_, <br /> Owner's Name Owner's Phone Number � � � <br /> Owner's Address � �S � �I 2 <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> �-�-_-�.�_.___.�_..�'---- - - - - - - - - - - — - -- — - ---- — - - --- .._._..��___. � <br /> Job Address �Lot# �� <br /> Sub Division Parcel# <br /> c�_��._..�._„�r_�._._.:��._....._.. --��___.u_� -- �_w���..,,...._._�.m__,_...v.e_—�.�._._�.._._�=.��n_s�...,w�...._v�-.�.�.. _._,.�__y:_..m..._r.�.,.____.__.Y..__�� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANPIUAL <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 /> tr y emi �n t er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum �ZCi% <br /> Fire Alarm ,� ❑ ❑ �'9• � � Sparklers �( <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Instaliations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � 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 /> �_:.a__v_.__ .�.___._..._._—___._.,.___ ,�..,..w �:_.y..�.._,...�,..�.�_._._.��_�.3--�---- --.-_�.��._. --.�..�__�r___._.. �..___ -._�..�.�_ <br /> Contractor � � Company <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 Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/�1 Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> t---- - - - - - <br /> ---- ..�--.�_ _._-- ---:. ..:�,..,.._.,_ _..____�_._.__ ___-__�_: - �_..._._ _ _______._a_._.m__ n_.- -.•--.---__._.,..---- _�_.--..______ �.., _.._,��__ve_., <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 work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcei#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />