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<br /> <br />. <br />813-780-0'tl20 <br /> <br />Date Received <br />~r~~~ <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />~ T_old" ""OM No","" I <br /> <br /> <br /> <br />&~~fr~:~ <br /> <br /> <br />__ __~l III_..m!IIlIlIi -',A WIi!l!I- <br /> <br />Bio-Hazard Waste Storage - ANNUAL D Fumigation Tent <br /> <br />Comm Exhaust Kitchen Hood/Duct D Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> <br />D Hood Installation <br /> <br />D LP/N~tural Gas-Installation <br /> <br />D- LP/Natural Gas-ANNUAL Sale <br /> <br />~ Places of Assembly-ANNUAL <br /> <br />City of Zephyrhills 'Fir-e <br />Permit Application <br />. r <br />r <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address I <br /> <br />Job Add~" F ;;; "; fa~ <br /> <br /> <br />Sub Division t <br /> <br />D <br />0' <br />D <br />D <br />D <br />o <br /> <br />~ <br /> <br />D <br />f'- <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIANI <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALl <br />Signature <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address <br /> <br />Directions: <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />I9!!!tI ~ ~ ~ <br />. Sprinkler D 0 0 0 L-J <br />Doooc=J <br />DO ooc=J <br />Doooc=J <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 Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />~~b(g~ <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br />,,~~~~< <br /> <br />II <br /> <br />D <br />o <br />D <br />o <br />D <br />D <br /> <br />Recreational Bum <br /> <br />Sparklers <br /> <br />Sprinkler System Installations <br /> <br />Standpipes (Sprinkler Sys) <br /> <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br /> <br />-'liili 1:1__ <br /> Company <br /> Registered <br /> License # <br /> Company <br /> Registered <br /> License # <br /> Company <br /> Registered <br /> License # <br /> Company <br /> Registered <br /> License # <br /> Company <br /> Registered <br /> License # <br /> <br />~.... <br /> <br />W-~I.J <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y I N I <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 />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 />