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813-780-0020 City of Zephyrhills Fire _ Fax-a�aaao-oo2� <br /> � - �' Permit Application <br /> Date Received r' � ` Phone Contact fo[Permity_� � � <br /> �:::;:._� -_°_ ___�.^._�_.,_.._..._ �_._.._..__..�_ _.__�_..��_�__.._.�-.�--..__.��.____..,a.��.�,.-...a_=�,..�._.,�____._..�„_____a..._,__.__,...�... - - -.�.�,_..�_._,_._.... <br /> � � � <br /> Owner's Name � G Owner's Phone Number <br /> Owner's Address � Q / <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> C`�:'v___.__�..�_ - - -- -- --- �,.._...._- --- <br /> Job Address � Lot# � <br /> Sub Division Parcel# <br /> c�;_�_��..�a..�.a.�_°-�-- .__..0_.�_<__.._-- __._.o _�.�.A -- �_. ,�,...:__.�,�e-.,�._.._�._.e.__�ud.��4�.�.a..°-�..�::r <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � 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 /> t y emi �n t er �/��� <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum 1 <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers Y <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <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 /> � Other: <br /> � r_...___.___...a .�w.u.__� - - .,�...,_..�_...._�,..a__-,�_______.�- -:� �_,�_.�.�...�. ___..�._ ,�..,�..._. <br /> Contractor � Company s C' <br /> Signature Registered /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/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/I� Fee Current Y/N <br /> Address License# <br /> ~ _ _,�_,_.,_._h:.,�,�,_ ..�. -- <br /> . <br /> - - __.._1.>.::�. ___���,�_:.�.. . ._:.v:.,.r_._�.�,�.._ <br /> G�..: �- _----.��_...�___.�...._.._,...�___._,1-�._.�_.__„._m___�_,....�...____.�_......_..,....___ �,..__. ______.._ <br /> Directions: <br /> Fill out application completely. <br /> Owner&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. Parcel#-obtained from Property Tax Notice(http:!/appraiser.pascogov.com) <br />