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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Re�eiveo�" � � Phone Contact for Permit ,���y� <br /> �M��__.d�_-_._�___ _�.�.,�._�..______��_ ---- ....,_�_,.�.�_..��_ ,�.��._.._._--- - �._...�_.v ....__. <br /> Owner's Name � � ��� Owner's Phone Number � � � <br /> Owner's Address 1�v � 1.� l � � <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> ��_.—r__.._.�� -- -- - - - - - .._.�____� <br /> Job Address o a Lot# � <br /> Sub Division Parcel# <br /> G"�.:=r.�.,_,_._....�..�...eaa..._��_...:,..,..,.w.�.d._..,_._._ _:_::.-.......<.....J.�.�.....____..o...�.�..., --"---,n..._.,.�d.�..._.�._�_v...a.._.W d..-__�_..---,..._....�..�...»__>._..._...�� - <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � 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 mi �n t er ,^� <br /> ��l/ <br /> Sprinkler ❑ ❑ � Recreational Burn � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers �,S <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofingffar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> QOther: <br /> �.-a_,._:i...y..____.,,.�._.._:__�.._ _,_.ua.:._ - -.,._�.. - __. �.�._....�...�„�..a.�.._ _-___._r_.,a.__..�_. --- - - . �.�,- -__:. <br /> Contractor f!-,vt `Y�vt.� 'f"�-e- GV�— Company <br /> Signature Registered Y/ 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 /> r---- �---- -- - <br /> ______._�_____..�._.__,_- -- - _._�_._�,-----.---__.._ .._ . _ _a.._--_____-�_�_.�_ ___._._ __� _,___ .----_..�_.,,_ _---- __a�.,_._.__.____._-, <br /> Directions: -• ---_�._.__ _. �__,.,._a_ <br /> Fill out application completely. <br /> i 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 />