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<br />813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 <br />Permit Application <br /> <br />"'~;;~;~~::'~::'~"'~'~mi!imi1i!i\%!!i\;1"ii~i:"I~:g,3i'i""Ni'"i'di,,,ti~~~\iWWIJtI@_!@IJt;'I@_i%t_!!i1A;_$_4%W_ii!M.@'_r_H~~:'%~;~~~~~~~@f,,,!L?1,:2:,,,,,,tL~,12::JTJiJ~'~i~" <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address I <br /> <br />Job Address b 9 s 7 ;V\e.d; (p I <br /> <br />Sub Division <br /> <br />\/ i e \A/' l-D..,e <br /> <br />12>/ ] <br /> <br />II Z31 II 3301 <br /> <br />Owner's Phone Number <br /> <br />h:lIs 1= L :1"55'-11... <br />Titleholder Phone Number I <br /> <br />II <br /> <br />II <br /> <br />pL <br />I <br /> <br />I Lot# <br /> <br />7eph'fl'"h:il ~ <br />I Parcel # <br /> <br />35S\..j2 <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Contractor <br />Signature <br />Address <br /> <br />Signature <br />Address I <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature . <br />Address I <br />OTHER <br />Signature <br />Address <br />Directions: <br /> <br />Bio-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 D 0 0 0 L-J <br /> <br />Fire Alarm ~ 0 0 ~ <br /> <br />Hood Cleaning D 0 0 0 C=:J <br /> <br />Hood Suppression 0 0 0 0 C=:J <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <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 />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch RoofingfTar Kettle <br />D Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <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 />A To+",l 5..lv+;o-'\ <br />~ I Fee Current <br /> <br />E. f [)Do() L{ '-II <br /> <br />Ci'/N <br /> <br />Y/N <br /> <br />Fee Current <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/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 />