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$13-780-Q020 City of Zephyrhills Fire ` i Q��� Fax-813-780-OQ29
<br /> Permit Application ��
<br /> Date Receivgd �� � Phone Contact for Permit �� �
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<br /> Owne�s Name f �� 1/� Owner's Phone Number � � '
<br /> Owners Address (.� �� r
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � �
<br />( Fee Simpie Ttlehoider Address
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<br /> Jab Address Lot# ��
<br /> Sub Division Parcel# •
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<br /> � Bio-Hazard Waste Sttarage-ANNUAL �� Fumigatian Tent , �
<br /> � Comm Exhaust Kitchen HaodtDuct Q Nazardous Materiai(Tier II or R4 Facili#y}ANNUAI.
<br /> � Controlled Bum - � Nood Installation
<br /> '� Eme enc Generator�30 kw LP/t3aturai Gas-lnstailation r�
<br /> � r9 Y �
<br /> �' � V�
<br /> � Emergency Generator>30 kw LP/Natural Gas- L Sale � ''1�
<br /> � c J
<br /> Fre Protec#ion Mainfenance-ANNUAL Places o Assembly-ANNUAL
<br /> �y em � er
<br /> Sprinkter � ❑ O O � Rec�eatlonai Bum
<br /> Fire Alarm � ❑ � ❑ � � Sparklers
<br /> Flaod Cleaning � Cl ❑ ❑ �� � Sprinkler System 4nstatiations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(3prinkler Sys)
<br /> � Fire Alarm Instattation � 7orch Roofing/Tar Kettte
<br />, � Fire Pumps � Q Waste Tire Storage ANNUAL
<br /> � F{ammabie Applicatian-ANNUAI ' r— 1 Valuation of Project
<br /> � Fuel Tanks
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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 I 1� Fee Current Y 1 N
<br /> � Address License# �
<br /> i PLUMBER Company
<br /> ' Signature Registered Y/N Fee Current Y/N
<br /> � Address L,icense#
<br /> MECIiANICAL Company �
<br /> �� Signa#ure Reg�stered Y/iU Fee Current Y/N �,
<br /> Address l.icense# I
<br /> � dTHER Company
<br /> I Signature Registered Y(N Pee Current Y(N
<br /> I)
<br /> Address License#
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<br /> �Directions:
<br /> Fit(out application completely.
<br /> Owner 8�Contractor sign back of application,notarized(Or,copy of signed contract with owner)
<br /> Ef over$2500,a Notice af Cammencement is required{Mechanicat work over$5000)
<br /> Suppiy two(2)sets of drawings with applicable documentation
<br /> Allow 10-1 A days for review after submittal date. Parcel#-obtained from PropeRy Tax Notice(http:!/appraiser.pascogov.com)
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