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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date Receiv�d �� ��o Phone Contact for Permit � ( 3 7 ssg - 7 C�
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<br /> Owner's Name sv v�v�.2✓�-'f' �" G{✓rG�Qc.- f 'l Owner's Phone Number � � �
<br /> Ovmers Address �� Z-� ,�n �
<br /> Fee Simple Titleholtler 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-Hazar orage-ANNUAL � Fumigation Tent
<br /> � mm Exhaust Kitch Hood/Duct � � ,Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> / � �� Controlled Bur Hood Installation
<br /> � E ncy Generator<30 kw � LP/Natural Gas-Installation `'�
<br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
<br /> � Fire P�otection Maintenance-ANNUAL � Places of Assembly-ANNUAL
<br /> tr y emi � t er ,
<br /> Sprinkler � ❑ ❑ ❑ ��� � Recreational Burn
<br /> Fire Alarm � ❑ ❑ ❑ ��� � Sparklers
<br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprink�er Sys)
<br /> � Fire Alarm Installation � Torch RoofingfTar Kettle
<br /> � Fire Pumps " � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � Flammable Application-ANNUAL ValU2tlOf1 Of P�OjBCt
<br /> � Fuel Tanks
<br /> �'
<br /> � Other: � �-R�
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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 I � • Company , �
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address � License#
<br /> MECHANICAL I Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address � License#
<br /> �
<br /> OTHER I Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
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<br /> Directions: J
<br /> 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(http://appraiser.pascogov.com)
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