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<br />813-780-0020 <br /> <br />City of Zephyrhills 'Fir-e <br />Permit Application <br /> <br />if 1110 <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br />Igl ~ <br /> <br />:I::Z:Z 'j <br />II <br /> <br />Parcel # <br /> <br />Owner's Name <br /> <br />~::l <br /> <br />c:tflNE)C <br />gLlIO. <br /> <br />f..e ST. <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <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 />Do 0 DC=] <br />Do''toc=] <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br />~Suppress~ <br />Fire Alarm Installation <br /> <br />~ F,,' T<ok, <br /> <br /> <br /> <br />D Other: I <br /> <br />contractor! ~ ''"""'1' ~' <br />Signature : ~ p(.., ======== <br /> <br />Address <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />Owner's Phone Number <br /> <br />!1~D8g <br />II <br /> <br />Date Received <br /> <br />Owner's Address <br /> <br />t: oN & <br />G IfLL <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />I Titleholder Phone Number I <br /> <br />Job Address <br /> <br />niAL <br />i <br /> <br />6A-LL f> L 1/ .6. <br /> <br />I Lot# <br /> <br />I <br /> <br />Sub Division <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <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 />Address <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />~~~w.oo <br /> <br />I Com"'f 1((IA-L F ILl f"~UIPMENt <br />Y/N J Fee Current l Y/N J <br />I I <br /> <br />I Y/N I Fee Current Y/N I <br />I I <br /> <br />I Y IN <br />I <br /> <br />I Y IN <br />I <br /> <br />I Y I N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <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 />Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />