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<br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br /> <br />City of Zephyrhills Fir-e <br />Permit Application <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br /> <br />CII/LI'.j <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br />II <br /> <br />Fee Simple Titleholder Name <br /> <br />II <br /> <br />I <br />I <br />17~~~ <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />C~/( <br /> <br />f3{ <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />I Lot# <br /> <br />Parcel # <br /> <br />D Fire Alarm Installation <br /> <br />D <br />B <br /> <br />D Fuel Tanks <br />D Other: I I <br /> <br /> <br /> <br /> <br /> <br />ELECTRICIANI Company <br />Signature , Registered Y I N Fee Current Y I N <br /> <br />Address I License # <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Blo-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 />D 0 0 0 c::=:I <br />D 0 0 0 c::=:I <br />~D (0 c::=:I <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <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 /> <br />Hood Installation <br /> <br />LP/Natural Gas-Installation .." 1 ~ 1 ~ jJ-!' . <br />LP/Natural Gas-ANNUAL Sale ",liP ~. --, II <br />Places of Assembly-ANNUAL;) J.- v' Jl? .1;0,' .~. J.k:;r- <br /> <br />Recreational Bum , '\ ~ ~~d \ ~ <br />Sparklers lY ~ ( . - <br />Sprinkler System Installations et <br />Standpipes (Sprinkler Sys) D <br /> <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />PLUMBER Company <br />Signature Registered <br />Address I License # <br />MECHANICALI Company <br />Signature Registered <br />Address I License # <br />OTHER Company <br />Signature Registered <br />Address License # <br />Directions: <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 />Y I N I <br /> <br />Y/N <br /> <br />Fee Current <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 />