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813-780-0020 City of Zepliyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date Re�eived � I Phone Contact for Permit��,�'�
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<br /> Owner's Name � Owners Phone Number � � �
<br /> Owner's Address � � �1r �
<br /> Fee Simple Titleholder Name j Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address ;
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<br /> Job Address � Lot# �
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<br /> Sub Division i Parcel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL i � Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct I � Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> � Controlled Bum � � Hood Installation
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<br /> � Emergency Generator<30 kw j � LP/Natural Gas-Installation
<br /> � Emergency Generator>30 kw � � LP/Natural Gas-ANNUAL Sale
<br /> � Fire Protection Maintenance-ANNUAL d Places of Assembly-ANNUAL
<br /> try emi �n t er I
<br /> Sprinkler � ❑ ❑ ❑ B � Recreational Bum
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers
<br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm Installation I � Torch RoofinglTar Kettle
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<br /> � Fire Pumps � � Waste Tire Storage ANNUAL '
<br /> � Fire Works i
<br /> � FlammableApplication-ANNUAL i Valuation of Project
<br /> � Fuel Tanks �
<br /> Q Other: �
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<br /> Contractor � � Company
<br /> Signature � Registered Y/N Fee Current Y/N
<br /> Address ; License#
<br /> ELECTRICIAN � Company
<br /> Signature i Registered Y/N Fee Current Y/N
<br /> Address � License#
<br /> PLUMBER I Company
<br /> Signature � Registered Y/N Fee Current Y/N
<br /> Address � ! License#
<br /> MECHANICAL i Company
<br /> Signature ' Registered Y/N Fee Current Y/N
<br /> Address � License#
<br /> OTHER � Company
<br /> Signature i Registered Y/N Fee Current Y/N
<br /> Address � License#
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<br /> Directions: Y I�
<br /> Fill out application completely. j
<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)
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