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8�saso-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received !�o�� Phone Contact for Permit _�.�e� <br /> ��..�_.��__�_-- _�_:_ ....___.� .___°���_.e.__...���...�_ -- _.._.�.._.�r - -_ �___.-�-v�= --- �.�..,,.__.�_.��....�._._��...�..e <br /> Owner's Name • c!S T l_ v l �- Owner's Phone Number � � � <br /> Owner's Address � ��� �� • � t ll.S �L J��7s�-- <br /> Fee Simple Titieholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> b�Address ��° ° _ - � —- - _ - - -- �Lot# � � <br /> Sub Division Parcel# <br /> �-�.d...._..a.._.._-_„�_.�..--��._._..�.�_.�.,_,...�,._..._._».�........_....�_��-___ �..����.�_.:..�-a--�,___._ . _....v_.�-_��__ <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 � LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> � emi � t er <br /> Sprinkler � ❑ ❑ O � Recreational Burn <br /> Fire Alartn � ❑ ❑ ❑ � � 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 - ValUBtlOf1 Of P�OJeCt <br /> � Fuel Tanks <br /> Q Other: <br /> r�� --_- ----- .�._.�.__ - -- — - —y___V.__._.._�.. - - -__�__�..._..,� - <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 <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 /> �� -,.,..�-_--,.�.__..._�-�_.._.._.�_..._,�_�_,�....._.,____.__�.__.._...,..._.---Y__.._....Y__._�.a..___�.__._._..,._�_ _°----_�w_..__._�.�_..�.-_.�_....._.,�__..__..ti_...�.w__.____.:��,-_ <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 iwo(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 />