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813-786-0020 City of Zephyrhills Fire Fax-813-780=002'1
<br /> Permit Application
<br /> Date Received �l�� Phane Gantactfar Permit T��_�����
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<br /> Owne�s Name s ��" . Qwner's Phane IJumber E� � �
<br /> Owners Address �J p � � � L '�a �
<br /> Fee Simple Titlehol�er Name Titleholder Phone Number � � �
<br /> Fee Simple Titleho�der Address
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<br /> Job Address Lot# �..�
<br /> Sub Division Parcel#
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<br /> �� �� Bia-Hazard Waste�Storage-ANNUAL �����l� ��� Fumigatian Tent��Y � ���
<br /> Q Gomm Exhaus#Kitchen HoodlDuct � Hazardaus Ma#erial{Tisr 11 or RQ Facility)ANNUA�
<br /> � Cantrolled Bum � Hood Installation
<br /> � ,� �mergency Generator<34 kw � LPINatural Gas-Installation �
<br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
<br /> � Fire Protectian Maintenance-ANNllAI � Places af Assembiy-ANNUA!
<br /> try emi � t er
<br /> Sprinkier � ❑ ❑ � , � RecreaYiona!Bum
<br /> Fire Alarm � ❑ ❑ O � � Sparklers
<br /> Haod Gieaning � � ❑ ❑ � � Sprinkler System Instailations ����`
<br /> )
<br /> Haod Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm Instai{ation � Tarch RoofinglTar Kett{e °
<br /> � Fire Pumps , Waste Tire Storage ANNUAL
<br /> Q FlammableApplication-ANNUAL �--� Valuation of Project .
<br /> � Fuel Tanks
<br /> - Q t�ther:
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<br /> Confractor� � ' Company
<br /> Signature � Registered Y/N Fee Current Y/N
<br /> Address E �icense# ��
<br /> ELECTRICIAN Company
<br /> - Signature � Registered Y/f�l Fee Gurrent Y!N
<br /> Address � License#
<br /> PLUMBER �I Company
<br /> Signature " Registered Y/N Fee Current Y/N
<br /> Address � �icense#
<br /> ��
<br /> MECHANICAL � Company
<br /> 8ig�ature Registered Y l N Fee Gurrent Y 1 Ct)
<br /> Address � License#
<br /> �
<br /> OTHER � Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
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<br /> Directions:
<br /> Fi(f auf applicatian completely.
<br /> Chnmer&Contractor sign back of application,notarized(Or,capy of signed contract with owner)
<br /> tf over$250Q a Notice of Commencement is required(Mechanicat work over$5004)
<br /> Supply twa(2)sets of drawings with applicabie documentation
<br /> Allow 10-14 days for reviaw after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pescogov.com)
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