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<br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fax-813-780-0021 <br /> <br />City of Zephyrhills -Firoe <br />Permit Application <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br /> <br />V~ c <br /> <br />I Parcel # <br /> <br />z.crH'/ /ZH11.L5 Lot # <br />Ip~ U z,/ tJ '/501) <br /> <br />~ <br />D <br />I <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen HoodlDuct <br />Controlied Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~~~~ <br />Sprinkler 0 0 0 0 L-J <br /> <br />Fire Alarm 0 0 0 0 C=:J <br /> <br />Hood Cleaning 0 0 0 0 ~ <br /> <br />Hood Suppression 0 0 0 0 C=:J <br /> <br />Fire Alarm Instaliation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />Sub Division <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIANI <br /> <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALj <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br /> <br />Signature <br /> <br />Address <br /> <br />o <br />o <br />o <br />o <br />o <br />f24 <br />D <br />D <br />D <br />D <br />o <br />o <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Instaliation <br />LP/Natural Gas-Instaliation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br />Sparklers <br />Sprinkler System Instaliations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing/Tar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />ll1""m--~ <br /> <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />, <br />.. Company ~ ,L <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company \ <br />Registered <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N Fee Current Y/N <br /> , , -, . . <br /> .l . <br />Y/N Fee Current Y/N <br />. ~ <br />Y/N Fee Current Y/N I <br />'~l l, <br /> . iY IN I <br />Y/N ' r:ee Current' <br /> . '~.''l' ::, .., <br /> <br />Directions: <br /> <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 />Aliow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />