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<br />81 ~780-0020
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<br />Owner's Name
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<br />Owner's Address
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<br />City of Zephyrhills Firoe'
<br />Pennit Application
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<br />;;r'~ Phone Num~;'_~]
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<br />Fax-81~780-0021
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<br />Fee Simple Titieholder Name
<br />Fee Simple Titieholder Address
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<br />~'>AlY~/tJ.$ I Lot # I I
<br />+- ~A 7?Or4 H.4J../...- - Parcel # J {J"Z- ?,.(, U () 9->PO 4t:W I
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<br />Titieholder Phone Number
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<br />~~20 kt9N:$IN~ AVE,
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<br />Job Address
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<br />Sub Division
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<br />Contractor
<br />Signature
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<br />Address I
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<br />ELECTRICIANI
<br />Signature
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<br />Address I
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<br />PLUMBER
<br />Signature
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<br />Address I
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<br />MECHANICALI
<br />Signature
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<br />Address I
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<br />OTHER
<br />Signature
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<br />Directions:
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<br />Bio-Hazard Waste Storage - ANNUAL
<br />Comm Exhaust Kitchen HoodlDuct
<br />Controlled Bum
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<br />Emergency Generator < 30 kw
<br />Emergency Generator> 30 kw
<br />Fire Protection Maintenance - ANNUAL
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<br />Sprinkler 0 0 0 0 L-I
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<br />DDDoC=:J
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<br />ODOOc=J
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<br />DDDDC=:J
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<br />Fire Alann
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<br />Hood Cleaning
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<br />Hood Suppression
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<br />Fire Pumps
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<br />Fire Works
<br />Flammable Application- ANNUAL
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<br />Fumigation Tent
<br />Hazardous Material (Tier II or RQ Facility) ANNUAL
<br />Hood Installation
<br />LPlNatural Gas-Installation
<br />LPlNatural Gas-ANNUAL Sale
<br />Place,S of Assembly-ANNUAL
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<br />Recreational Bum
<br />Sparklers
<br />Sprinkler System Installations
<br />Standpipes (Sprinkler Sys)
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<br />Torch RoofinglTar Kettle
<br />Waste Tire Storage ANNUAL
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<br />Valuation of Project
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<br />Company
<br />Registered
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<br />Fee Current I
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<br />Y/N
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<br />License #
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<br />License #
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<br />Registered Y/N I Fee Current Y/N
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<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 (http://appraiser.pascogov.com)' .' ~
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