|
813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date�eceived� Phone Contact for Permit ��
<br /> �s^-:�=r�.�•.tai�-:.:.�a;-»-....x�.....�-...,.....,,�.,.,.........._.....,___ex:�.��...�.�.��.�.��x�:.»;�:,�ar�.�Y.:..saw�::•..-::c.�-:.:��::���=:»v.c�c�--:._�u::e....,�._.MY�,..�,.-�.��..`..�.�..�....a
<br /> .. f � � �
<br /> Owner's Name Q � Owners Phone Number �p�
<br /> Owner's Address ` L � '
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address 1
<br /> i.-=._,�s;:r�:._:�;'^.:..,,.._, �_....-~,.,...��-°,�..h:.4.�T-..~.��^.....^:.�,.::.-a�..----�=:'��._.,.----,.-..,_..-.,.-,_..� - "^�.�<�.."->F'^��.-�—,
<br /> Job Address Lot# ��
<br /> Sub Division Parcel#
<br /> tir_.•,.;=.-t:'�>.�"".-,:��;~:y.,..,^,�."�",:�.•�'�.+'�..��c�•-'^._,..�;.;"�'-:�^—,'�'n,.-....T�'""`;�.-�:.-���;�_� .`�'.�.:.z;.:��.Jfi:u.�•�;.��:t.,�'-.;:T�,�:_.r"�'«"�,..,.b....,_:..��_:`s~:....,.�"-^^.-�+*_r�:�=_.,,'"�"^e_.,,^�.�;`�•,^.;5
<br /> � Bio-Hazard Waste Storage-ANNUAL y� Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> � Controlled Bum � Hood Installation
<br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation
<br /> � Emergency Generator>30 kw � /Natural Gas-ANNUAL Sale
<br /> � Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL
<br /> �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 Roofing/Tar Kettle
<br /> � Fire Pumps a Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � FlammableApplication-ANNUAL Valuation of Project
<br /> � Fuel Tanks
<br /> Q Other:
<br /> s�..1.-a<;�< .�-�:.�-:. .., ,..�,� ::�-....:-.*�,�.,�N-:.,s.:M;r<-d.-�...'_�;.��.,.:>����`:.�����•r�:��_,n�-,....._r�•.�.:�,.,.���...}�r��-°-::_r�--�.✓.a�a��.�.<:�-N�.�..���k:.~;�
<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/�1
<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 . ,v > �,, - � ,. .. - .. . ��..�. ;.,.�-, �.�._�.,,.,.:>..:.:f�.....:_.,,Y�;s-;:.:.�.:��.,.
<br /> �-�....-...�.a,.:.,�...__4-_.,:_,-..Er.,.:.�.,..�.�.:..<�..��.:_.,_..�_._.:._.-�-_;� _ - �:.�..�:�::��-�:...,.�,._..,. ,::>..v,�-:��N_. .:_�:., .._ .�� .. . .,. ...� _ _ . .� .._. � - - '
<br /> � _.. =:-y,-:-
<br /> Directions:
<br /> i 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(httpJ/appraiser.pascogov.com)
<br />
|