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<br />. 813-780':-0020
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<br />Date. ~~~~i~~.?~,z,;:'c';i;J
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<br />Owner's Name
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<br />Owner's Address
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<br />City of Zephyrhills Fir€
<br />Permit Application
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<br />Fee Simple Titleholder Name
<br />Fee Simple Titleholder Address
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<br />Fax-813-780-0021
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<br />I 8\3
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<br />1.1 LJ
<br />II 7<i 2-11
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<br />Phone Contact for Permit
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<br />I Own~~s Phone Number
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<br />I Titleholder Phone Number I
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<br />II
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<br />II
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<br />D Fire Alarm Installation
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<br />B
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<br />D Fuel Tanks
<br />D Other: I
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<br />Sub Division
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<br />Contractor
<br />Signature
<br />Address I
<br />ELECTRICIANI
<br />Signature
<br />Address I
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<br />PLUMBER
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<br />Signature
<br />Address I
<br />MECHANICALI
<br />Signature
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<br />D
<br />D
<br />D
<br />D
<br />D
<br />D
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<br />Bic-Hazard Waste Storage - ANNUAL
<br />Comm Exhaust Kitchen Hood/Duct
<br />Controlled Bum
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<br />Emergency Generator < 30 kw
<br />Emergency Generator> 30 kw
<br />Fire Protection Maintenance - ANNUAL
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<br />Sprinkler D 0 0 0 L-J
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<br />.;/F~7;!~' r~::7
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<br />Fire Alarm
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<br />Hood Cleaning
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<br />Hood Suppression
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<br />Fire Pumps
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<br />Fire Works
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<br />Flammable Application- ANNUAL
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<br />I Lot#
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<br />Parcel #
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<br />o
<br />o
<br />o
<br />D
<br />D
<br />D
<br />D
<br />o
<br />o
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<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 />Places of Assembly-ANNUAL
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<br />Recreational Bum
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<br />Sparklers
<br />Sprinkler System Installations
<br />Standpipes (Sprinkler Sys)
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<br />Torch Roofingrrar Kettle
<br />Waste Tire Storage ANNUAL
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<br />Valuation of Project
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<br />Company
<br />Registered
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<br />Y/N
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<br />Fee Current
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<br />Y/N
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<br />Address I I License # I I
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<br />OTHER ]~ 6 /1 f Compa", I ~r'rY ;Fh_
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<br />Directions:
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<br />License #
<br />
<br />Company
<br />Registered
<br />
<br />Fee Current
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />Company
<br />Registered
<br />
<br />Y I N I
<br />
<br />Y/N
<br />
<br />Fee Current
<br />
<br />License #
<br />
<br />Company
<br />Registered
<br />
<br />Y/N
<br />
<br />Fee Current
<br />
<br />Y/N
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<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)
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