HomeMy WebLinkAbout21-3053City of Zephyrhills
5335 Eighth Street
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
FIRE-003053-2021
Issue Date: 10/20/2021
REINSPECTION FEES: (c) With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c) the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection, whichever is greater, for each subsequent reinspection.
Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit required from other governmental
entities such as water management, state agencies or federal agencies.
1=X=1 1r'f4tTj
accordance with City Codes and Ordinances. N6'OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE
10 ffik-LONJAUT w:F-1110 MIAZI
813-780-0020
Date Rec3�ived
Owner,VName
Owner's Address
Fee Simple Titleholder Name
Fee Simple Titleholder Address
Job Address
Sub Division
F-
'U'n(o
Bio-Hazard Waste Storage - ANNUAL
Comm Exhaust Kitchen Hood/Duct
Controlled Burn
Emergency Generator < 30 kw
Emergency Generator > 30 kw
Fire Protection Maintenance - ANNUAL
M
Sprinkler F-1 0
Fire Alarm ❑
Hood Cleaning ❑
Hood Suppression ❑
Fire Alarm Installation
Fire Pumps
Flammable Application- ANNUAL
Fuel Tanks
Other: F ('71 P 17 -171 �111 11
Phone Contact for Permit
Titleholder Phone Number
C �1E l
Fax-813-780-0021
PL -S,-5 5,1 �
Lot #
Fumigation Tent
Hazardous Material (Tier If or RQ Facility) ANNUAL
Hood Installation
LP/Natural Gas-Installatior
of Assembly -ANNUAL
Recreational Burn
Sparklers
ElSprinkler
System Installations
ElStandpipes
(Sprinkler Sys)
ElTorch
Roofing/Tar Kettle
Waste Tire Storage ANNUAL
IMMEDMIM
Contract
Company
Signature \'Jll
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Registered
Current
Ad;r'ess
License #
E-
ELECTRICIAN
Company
Signature
Registered LY
/ N
Fee Currant
/ N��
Address
License #
PLUMBER
Company
Signature
Registered
YT-N-7
Fee Current I
YIN
Address
License #
MECHANICAL
Company
Fe �Current
Signature
Registered
YIN
Y I N��
Address
License #
OTHER
Company
Signature
Registered
Y/N
Fee Current
Y/N
Address
License
Z.11 �11
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Directions:
Fill out application completely,
Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner)
If over $2500, a Notice of Commencement is required (Mechanical work over $5000)
Supply two (2) sets of drawings with applicable documentation
Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (hftp://appraiser.pascogov.com)