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<br />813-780-0020 <br /> <br />Date Received J <br />W~'km.t+$WRWjWi@MilW1~mK%%W*1WiilW4 .;,;i;'~,~~i~ <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />City of Zephyrhills Fire Fax-813-780-0021 <br />Permit Application <br /> <br />rJ.Li,ie&#"",,,,,L____~_!_d@_~:;__~~~==~J_fL}_lJi2,t:,Jj,,'~,~f21 <br />{~f f/ J%? 0. )11 ~ I Own~~'s Phone Number I II II <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />II <br /> <br />Blo-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 />Sprinkler 0 0 0 0 L-J <br />Fire Alarm 0 0 0 0 c=:J <br />Hood Cleaning 0 0 0 0 c=:J <br />Hood Suppression 0 0 51 0 c=:J <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Appllcation- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Lot # <br /> <br />I <br /> <br /> <br />Parcel # <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />D <br />D <br />B <br />D <br />D <br /> <br />Contractor <br />Signature <br /> <br />Address <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 />Directions: <br /> <br />D Fumigation Tent <br />D Hazardous Material (TIer II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />D Places of Assembly-ANNUAL <br /> <br />D Recreational Bum <br /> <br />D Sparklers <br /> <br />D Sprinkler System Installations <br /> <br />D Standpipes (Sprinkler Sys) <br /> <br />D Torch RoofingfTar Kettle <br />D Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Other: <br /> <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />License # <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br />Registered <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />License # <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 />