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• • <br /> s�saao-oozo City of Zephyrhills Fire Fax-e�saso-ooz� <br /> Permit A lication <br /> PP <br /> Date Received Phone Con a f r <br /> t ct � �ermit. ��-� '�j�� �{��j� <br /> Owner's Name � �Q �''S�� Owner's Phone Number D�� �1;�R' 'f,��/ <br /> Owner's Address Q1..1 �]�, � l�`1//� �(,�`� �v y V I/ 3��,D��/ <br /> Fee Simple Titleholder Name Titleholder Phone Number � � �� <br /> Fee Simple TitleholderAddress <br /> Job Address �'J�JJ l,'�ii.L.L �`�i���. 2��h r h,'�.Ll�a �� ✓���� Lot# � <br /> Sub Division Parcel# �v d���!���o�j�,''���+�o�� <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 C�� <br /> Fire Protection Maintenance-ANFIUAL � Places of Assembly-ANNUAL `/ V <br /> tr y emi �n er � �' <br /> Sprinkler � ❑ ❑ p � � Recreational eurn <br /> Fire Alarm � ❑ ❑ � � Sparklers � <br /> Hood Cleaning ❑ ❑ � � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> 0 � <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 i <br /> � Fuel Tanks <br /> Q Other: <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 r- <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 • �• J Company y1/ � �� 1 <br /> Signature �/��f�1�' Registered �1 N Fee Current Y/N <br /> Address � i �� � �� � r�„� . " �DLicense# '�(.,� �(� � <br /> . , <br /> �. , . <br /> Directions: ' <br /> Fill out application completely. � <br /> i <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) i <br /> If over 52500,a Notice of Commencement is required(Mechanical work over$5000) I <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 /> rl�� ALI�A�� �e��LJL'.L <br /> � <br /> � <br /> . � <br /> I <br /> � <br /> i <br /> � <br />