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<br />813~780-0020 <br /> <br />J? .1~1~ <br /> <br />Fax-813-780-0021 <br /> <br />City of Zephyrhills Fir-e <br />Permit Application <br /> <br />i {Jtr L{r.I;fZljfJ~'o/--iC!<J <br />I <br />I <br />: ,,f0' <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Iff/? ~ <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 />~~~~ <br />Sprinkier D 0 0 0 L-J <br />Fire Alarm D 0 0 0 c=J <br />Hood Cleaning D 0 0 0 c=I <br />Hood Suppression D 0 0 0 c=I <br /> <br />Fire Pumps <br /> <br />Fire Works <br />Fiammable Application- ANNUAL <br /> <br /> <br />Phone Contact for Permit <br /> <br />Date Received <br /> <br />Owner's Phone Number <br /> <br />: I <br />II <br /> <br />: I <br />II <br /> <br />ELECTRICIANI <br /> <br />Signature . <br /> <br />Address I <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br /> <br />Signature <br /> <br />Address I <br /> <br />OTHER <br /> <br />Signature <br /> <br />Address <br /> <br />Titleholder Phone Number I <br /> <br />~~ ~~ <br /> <br />I Lot# <br /> <br />Sub Division <br /> <br />Parcel # <br /> <br />~ ~~,~~~_"'OO" <br /> <br />D Other: I <br /> <br />contractor! A/ ~ uJ JL. A_ <br />Signature ........-/ 7 ~A./ r~ <br />Address . <br /> <br />D <br />D <br />D <br />D <br />D <br />D <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 />~P/Natural Gas-ANNUAL Sale <br />ITI 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 />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Job Address <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y I N Fee Current <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y I N Fee Current <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y I N Fee Current <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 />