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<br />813-780-0020 <br /> <br />City of Zephyrhills Fir,e <br />Permit Application <br /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />~I <br />lD13 ':> <br />I <br />I <br />I~~ <br />I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Phone Contact for Permit <br /> <br />Owner's Phone Number <br /> <br />1/1 ({ ~ II <:Z';;)'t~ I <br /> <br />I Titleholder Phone Number I <br /> <br />II II <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />I Lot # I <br /> <br />D <br />D <br />D <br />D <br />D <br />~ <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 /> <br />a ~ ~ ~B <br /> <br />Doooc=J <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />D Fire Alarm Installation <br /> <br /> <br />II F~I T."~ <br /> <br />D Other: I <br /> <br />~i~~~~~::r ! ~ ~~_ <br /> <br />Address I ~"'l'\l'1. k''h..~~ ~\ DQit..<:.(\-i) <br /> <br />ELECTRICIANI <br />Signature . <br />Address I <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Parcel # <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />o <br />D <br />D <br />o <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ~Ut)v~ p <br /> <br />Hood Installation 5~tI " 0 ~ <br />. 11 ~ <br />LP/Natural Gas-Installation rr - <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofinglTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />f l.3~~~S <br /> <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALj <br />Signature . <br />Address I <br /> <br />OTHER <br /> <br />Signature <br /> <br />Address <br /> <br />Directions: <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 /> <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />I~~~~I~~~ <br /> <br />I E"~ . CttllCi4~ I <br /> <br />I Y I N I Fee Current Y I N I <br />I I <br /> <br />I Y I N I Fee Current <br />I <br /> <br />I Y IN' Fee Current <br />I <br /> <br />I Y IN <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <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 />