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. <br /> 8�3-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received ' Phone Contact for Permit � � � <br /> ��-.�-w__�=_----_ - ---__._�_.....,-..v.: _ ...._:A�.t_� - _ - _._.��`..___.._._..�.��-�...___�___-____ __._�.. - — ...,,.�-�... <br /> Owner's Name ` ` � ' � b L.�--�'i Owner's Phone Number 3�J (�S� ��� <br /> Owner's Address ,3 ��L�, r' �t-. 3 3�� <br /> Fee Simple Titleholder Name Titleholder Phone Number � � �� <br /> Fee Simple Titleholder Address <br /> G.'�"'.���__...____�,....�_. - °;,,,r�-- -- «__,,...,...:.`',.�`--' .�..�•_ -_*."�_ ..e_"-___.. <br /> Job Address Lot# �� <br /> Sub Division Parcel# <br /> �-�,_...._..�.`....__..d___t.:�::��...:._.�__,.o.�.�._-�-.�..�a�,_�..���__�v. - ...a_ �.�..__�__._.._...._._a_z.�_..__.�._��_.`_._.._...�.�...�...,-----��----� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Fiood 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 /> try emi �n t er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum � <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <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 /> Q Other: <br /> �:.�...w,�_>:------��.. e.,_.v - .-� _ __ - .�_.�...��.,.�..,...�..____�r�_.�,..�...._._�......._.,..r__._ - __av._n._.�R__ �. <br /> Contractor �� /� � � Company <br /> Signature l/� �/ 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 /> e=._:=,_ .e.._ .__._.._.,.._.__�._ _�Y.__.____.. .Y:�___,�_,_�____e__�__._.�..___..�_.�._.____..�._ ..�_.________..._...>.,�-__------------.r�.__n___....._..____ . __�_� �.�_.��-� <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 />