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s�3-7so-oo2o City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Rate Received �—i� Phone Contact for Permit C__� C� ��
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<br />� Qwner's Name Owners Phone Number �� C� C�
<br /> IOwner's Address
<br /> II Fee Simple Titleholder Name Tideholder Phone Number � �� �
<br /> i Fee Simple Titleholder Address
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<br />� Job Address Lot# C�
<br /> Sua Division Parce!#
<br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
<br /> � Gomm Exhaust Kitchen liood/Duct Q Hazardous Materiai{Tier II or RQ Facility}ANNUAL
<br /> � Controlled Burn � Haod Installation
<br /> � Emergency Generator<34 kw Q !.PlNatural Gas-Installation
<br /> � Emergency Generator>30 kw � L.P/Natural Gas-ANNUAL Sale
<br /> � Fire Profection Maintenance-ANNUAI. � Places of Assembly-ANNtlAL
<br /> Q'fr y emi � t er
<br /> Sprinkler � � Cl O � Recreational Bum
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers
<br /> Naod Cleaning � 0 ❑ ❑ � � Sprink(er System(nstallations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm Installation � Torch Roofingtfar Kettte
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Flammable Application-AtVNUAI � , r�— , Valuation af Project
<br /> � Fuel Tanks
<br /> � {3th@�:
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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 CuRer�t Y/N
<br /> Address License#
<br /> PIUMBER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address �icense#
<br /> MECHANICAL Campany
<br /> Signa#ure Registered Y/N Fee Current Y/iV
<br /> Address L(cense#
<br /> QTHER Company
<br /> Signature Registered Y!N Fee Current Yf N
<br /> Address � ' ' �\ License#
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<br /> Directions: --.�-_.._.__�..�_ �_.._._�__i _.�_. ____._._,.____ _ -__.�_-
<br /> Fii(out application completely. �� -
<br /> Owner&Gontractar sign baok of application,notarized(Or,copy of signed contract with owner)
<br /> If over$2540,a tVotice of Gommencement is required{Mechanicai wark over$5404}
<br /> Supply two(2)sets of drawings with appiicable documentation
<br /> Allow 10-14 days far review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
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