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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
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<br /> Permit Application
<br /> Date Received Phone Contact for Permit 1�— JI
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<br /> �Owners Name /� �'�
<br /> ��('/T L1J ��'`U l I Owner's Phone Number � � �
<br /> �Qwner's Address ��-�o� %� ��1�7� -J�% ��j
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address � f
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<br /> Job Address Lot# �
<br /> Sub Division Parcel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Faciliry)ANNUAL
<br /> � Controlled Bum � 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 /> t y emi �n 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 RoofinglTar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works I
<br /> � FlammableApplication-ANNUAL Valuation of Project ��I
<br /> � Fuel Tanks
<br /> Q Other: �
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<br /> ntractor� �b 4 Company
<br /> Signature ��L�2�'`�� 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#
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<br /> Directions:
<br /> Fill out application completely.
<br /> -�=-~-•
<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 worl��over$5000)
<br /> Supply two(2)sets of drawings with applicable documentation i
<br /> Allow 10-14 days for review after submittal date. Parcel -obtained from PropeRy Tax Notice(http://appraiser.pascogov.com) i
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