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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 I
<br /> ' ` Permit Application
<br /> ate Received Phone Contact for Permit ����l� l l
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<br /> wners Name �Q, S � � � Owners Phone Number
<br /> wner's Address ` -
<br /> :e Simple Titleholder Name Titleholder Phone Number � � �
<br /> :e Simple Titleholder Address '
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<br /> �b Address J 7 � �` ! `- � Lot# �
<br /> ub Division Parcel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> , � Controlled Bum � Hood Installa6on
<br /> � Emergency Generator<30 kw �LP/Natural Gas-Installation
<br /> � Emergency.Generator>30 kw � LP/Natural Gas-ANNUAL Sale
<br /> � Fire Protectton Maintenance-ANNUAL � Places of Assembly ANNUAL
<br /> �y emi �n er
<br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers F ���
<br /> Hood Cleaning � ❑ , ❑ ❑ � � Sprinkler System Installations -L��
<br /> Hood Suppression � ❑ ❑ O � � Standpipes(Sprinkler Sys)
<br /> � Fire Alartn Installation � Torch Roofing/Tar Kettle '
<br /> � Fire Pumps � Waste Tire Storage ANtdUAL ,
<br /> � FlammableApplication-ANNUAL (��, Ul� Valuation of Project
<br /> � Fuel Tanks
<br /> Q Other:
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<br /> :ontractor Company � S c�-�-�2
<br /> �ignature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> :LECTRICIAN Company
<br /> �ignature Registered -Y/N Fee Current Y/N
<br /> Address License#
<br /> �LUMBER Company '
<br /> iignature Registered Y/�I Fee Current Y/N
<br /> Address License#
<br /> AECHANICAL Company
<br /> iignature • Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> )THER Company
<br /> iignature Registered Y/N Fee Current Y/�l
<br /> Address � License#
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<br /> )irections:
<br /> Fill out application completely.
<br /> Owner&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(httpJ/appraiser.pascogov.com)
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