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<br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br /> <br />City of Zephyrhills Fir€ <br />Permit Application <br /> <br />813-780-0020 <br /> <br />Fax-813-780-0021 <br /> <br />r Yu \e..--t ' <br />13 ~ -309 - LDl.\"I"\ +~ gu~ i S11 <br />I LJ -f .J.. <br />8) <br /> <br /> <br />---=- h eJ.u.." , <br /> <br />Phone Contact for Permit <br /> <br />I Owner's Phone Number <br />Z-e ph '11' N n.) rL _ '3 3 5 4 2 ~ <br />o V Nt Y2-. I Titleholder Phone Number <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />OvJ r0[.YL_ <br /> <br />Parcel # <br /> <br />I Lot# <br /> <br />I <br /> <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature <br />Address I <br />OTHER <br />Signature <br />Address <br />Directions: <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen HoodlDuct <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 />Fire Alarm D 0 0 0 c=J <br />Hood Cleaning D 0 0 0 c=J <br />Hood Suppression D 0 0 0 c=J <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />D <br />D <br />D <br />~ <br />o <br />o <br />o <br />o <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br /> <br />Recreational Bum <br /> <br />Places of Assembly-ANNUAL <br /> <br />/~ tZ't~ <br />;;tJJ1.:--6:.-iZ~. <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofinglTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br /> <br />Valuation of Project <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />D Fire Alarm Installation <br /> <br />D <br /> <br />~ F~IT."" <br />D Other: I <br />~~~::::r I vCtvhn, ~ukL. <br /> <br />Address I <br />ELECTRICIANI <br />Signature . <br />Address I <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y I N I 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 />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 />