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<br />. 813,~78~-0020 <br /> <br />{F 1557 <br /> <br />Fax-813-780-0021 <br /> <br />City of Zephyrhills Fir,a. <br />Permit Application <br /> <br />[)~~e~ec:~i_ve.~. . _ .J . ... . J .. <br />i1b~iMJ:~):t*"nm:~I~~~~~~~<>i,OO$1%~ .i,~;~.,~~,''''',:t.,';<~;i~,o>.:lW~b;';:~<;<'~~'~''''''~~~~ . <br /> <br />Owner's Name- <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Phone Contact fur pe=>\!!fl_.-~_lL",_,Jl"w_"",,"M' <br /> <br />Owner's Phone Number <br /> <br />] '1L3 II 7~'%. 114~ <br /> II II <br /> I Lot# I <br /> <br />5"~) 0 <br /> <br />+i It.S'T 'P~S B" TC" 41 MJ Cu."U-Jr/ <br />"n! ~. 'ZJ!!pJ.Y~~'L-<5 ~ .p... 335"42 <br />. I ~ Titleholder Phone Number <br /> <br />Fee Simple Titleholder Address <br /> <br />I <br />I <br />I !)5J. 0 <br />I <br /> <br />~f~J~~~~~_~~~l.lBam~~a\lI. ~1 <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />D <br />D <br />D <br />B <br />D <br />ftfu~Wwf.m~m'i.~m~t1tmJlll <br /> <br />11""/1 <br /> <br />S, dEs r- <br /> <br />Parcel # <br /> <br />~~~f~f.i?:~~~~3 <br /> <br />~ IUltJ1~llll1t <br /> <br />~~M~m~~~* 11 <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~I::;emll~~ <br />Sprinkler D 0 0 0 L-.J <br />Fire Alarm D 0 0 0 c=J <br />Hood Cleaning D 0 0 0 c=J <br />Hood Suppression D 0 0 0 c=J <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br />Fuel Tanks <br /> <br /> <br />Contractor <br />Signature <br /> <br />Address <br /> <br />ELECTRICIANI <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />~~:L....,__,-, .., <br /> <br />Directions: <br /> <br />D Fumigation Tent <br />D Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/N~tural Gas-Installation <br />: ~atural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch RoofingfTar Kettle <br />D Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />~~~~~~~~~~2~l~.~~~~:~~jt2 <br /> <br />Company I <br />Registered <br />License # I <br />Company <br />Registered <br />License # <br />Company <br />Registered <br />License # <br />Company <br />Registered <br />License # <br />Company <br />Registered <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />.._'w....""" .. . m....._-.'.".''''-'..''''.............v:v-7 <br /> <br />n1 <br /> <br />n"'"" ,-~' 'w <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />- <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />"...L~~';~~~w.."'~""""~..,,"",..."..~"..,,_~,..._...~,,__~,~~..,~<WJ.......~... ._- <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 />Allow 10-14 days for review after submittal date_ Parcel # - obtained from Property Tax Notice (htlp://appraiser_pascogov.com) <br />