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<br />"813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />City of Zephyrhills Fife <br />Permit Application <br /> <br />"I1..-~Y <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br />II <br /> <br />I <br />I <br />17Qt'Q 6--tl1 i"7/. <br />I <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />II <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />I Lot# <br /> <br />Parcel # <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> <br />D <br />B <br />D <br />D <br />D Other: I I <br />i <br /> <br /> <br /> <br />ELECTRICIANI Company <br />Signature Registered Y I N Fee Current Y I N <br /> <br />Address I License # <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 />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 D 0 0 0 L---.l <br />Do ooC] <br />Do ooc=J <br />00 Pl"0C] <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Appllcatlon- ANNUAL <br /> <br />Fuel Tanks <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 />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />c& <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br /> <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <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 />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://appralser.pascogov,com) <br />