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\ <br /> .` 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> ��'' Permit Application <br /> Date Received � a Phone Contact for Permit � �_� <br /> �.�-...�_._.___.__-- -- ---_.---�r_._._____ .r_._...,.__�.- _..,._�...�_�°�._...-., w...�.__..u....,.._.---�-_=--�-. _ __ ��P__—,__°__-°-__...�__.�.�.,_..._.-_..�__,., <br /> Owner's Name PI ` c7d d G r�Ut m Owner's Phone Number p l �3 L��� <br /> Owner's Address �p,�� o G IJ �J� � �` / .f 1 ��S�� <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> L°--»�=W::��,:�....._- - - -- - -- - - -- - e -- - ..�...�-:.��.,_ . <br /> Job Address Lot# � <br /> Sub Division Parcel# <br /> .....L.___ __..���___.____.___"..��.__�._..�_.___ _ . _�....9._ _��- --- -- -- --° - --- - <br /> [�_�_.__�.,...._..s_.. . �,.'a�� .. _�__._.� a_ __ _Y._. . v..m,_... _.__,_.._ <br /> � Bio-Hazard Waste Storage;ANNUAL �p� �'� �� 4� Fumigation Tent ' ��.y_._,.__. �,_ ..______ __,� <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> t y emi �n t er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Burn � <br /> Fire Alarm � ❑ ❑ O � � Sparklers v � <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 3�� <br /> � Fire Works ` <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> L'.�.____�..�.___-_ :_....�LL�__.._.���._.___�_�._.._...�- - -..�...�_....,��.�.__ .�._w__.,...�.m�.�.- - --.,._:_- -- _a..._...�__��_.___���_.... <br /> Contractor � Company ( �[� CL C� <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/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> �.__. _ - - <br /> r.�.,_.Y..�_. .�,_.�._.--- .--- -_�K_,, ..-__,__.._.__._.._�..�.._._.__.___,_..____._ �_� �_.� ._._�..__�__ .�__J.�__.__.w�...---.,e...___, �._ _�._.._.____�.__�, <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. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br /> I <br />