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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date Receivet! I� _ Phone Contact for Pertnjt- �
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<br /> ��4wners Name � C i/�Q� Owners Phone Number
<br /> �Owner's Address /(p � Cj � S ��
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address .
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<br /> Job Address Lot# ��
<br /> Sub Division Parcel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent � �i
<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 I�
<br /> � Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale �
<br /> a Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL ,
<br /> � emi �n er_ `0" ' ���,
<br /> Sprinkler � ❑ ❑ ❑ B � Recreational Bum �
<br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers �
<br /> Hood Cleaning � � ❑ ❑ � � Sprinkler System Installations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm Installation � Torch Roofingffar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Flammable Application-ANNUAL Valuation of Project
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<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 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 /> Directians:
<br /> Fill out application completely.
<br /> Ovmer 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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