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<br />81~-780700~ <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />City of ZephyrhillsFir-e <br />Permit Application <br /> <br />/} ~~ V <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Phone Contact for Permit <br /> <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br />II <br /> <br />e~~=>':~'1 . <br /> <br />~ ",.",." Pho~ N"- I II II I <br />~_... ~~ <br />!...= _.! _ . ~,~ Lot> I I <br />D <br />D <br /> <br />D Hood Installation <br /> <br />D <br />D <br /> <br />D Places of Assembly-ANNUAL <br /> <br />o Recreational Bum <br />o Sparklers <br />o Sprinkler System Installations <br />o Standpipes (Sprinkler Sys) <br />D <br />D <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name I <br />Fee Simple Titleholder Address I <br />!! .~,;.~ ~ <br />Job Address I. ~, i"6 ~ 11 <br /> <br />Sub Division , <br /> <br />~ ~~~:.~",ml~OO <br /> <br /> <br />D Other: 1 <br /> <br />~~~::;:r I -~ ~ <br />Address i ~ 0 ~;; tbCf,l/;.: t-.O L ) <br /> <br />ELECTRICIAN <br />Signature <br /> <br />Address I <br /> <br />D <br />D <br />D <br />D <br />D <br />D <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 />Address <br /> <br />Directions: <br /> <br />BiD-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RO Facility) ANNUAL <br /> <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br /> <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 />DoooC=:J <br />DoooC=:J <br />o o~ OC=:J <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />Torch RoofinglTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />Valuation of Project <br /> <br />'F--L.- ~ U b~' <br /> <br />~l'iW:~"l'fI"""-~~&~_r 1!ffiiW"" .l~~ ~~~~ <br />Company 1 f';~ Y.1 ~ d;,.,L- <br />Registered Y I N I Fee clfrTent I Y I N I <br /> <br />~;'~d r:~~~;:~~~ ~N <br /> <br /> <br />License # I <br /> <br />Company I <br />Registered Y / N <br /> <br />License # I <br /> <br />Company I <br />Registered Y I N I Fee Current <br /> <br />License # I <br /> <br />Company 1 <br />Registered Y I N <br /> <br />~,~ <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />License # <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 (http://appraiser.pascogov.com) <br />