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<br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />./1 ~ if? <br /> <br />City of Zephyrhills Fir-e <br />Permit Application <br /> <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />ELECTRICIAN <br /> <br />Signature <br /> <br />Address <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature . <br /> <br />Address I <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br /> <br />Owner's Phone Number <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />II <br /> <br />Bio-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--' <br />Do ooC] <br />o 0 0 0 C] <br />Do ooC] <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />3 <br /> <br /> <br />~OOd Suppression <br />[2J Fire Alarm Installation <br />~ Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />D Other: <br /> <br /> <br />contractor! ~ ~ A fi ~ '. <br />Signature . _ . ~~ IT r G fted-eJ: <br />Address'lg25~1!.. i_ f.le~lAI~ ~ <br /> <br />fitrtYlV <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 />L,,,,,,,,-. ,--- <br /> <br /> <br />OTHER <br />Signature <br /> <br />Address <br /> <br />Company I <br />Registered Y/N I Fee Current <br />License # ~m(k:)~81o <br />Company I <br />Registered Y/N I Fee Current <br />License # I <br />Company I <br />Registered Y/N Fee Current <br />License # I <br />Company I <br />Registered Y/N I Fee Current <br />License # I <br />Company I <br />. Registered Y/N Fee Current <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Directions: <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 Properly Tax Notice (http://appraiser.pascogov.com) <br />