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<br />"------------.... <br /> <br />.... <br />813-780-0020 <br /> <br />Date ReceiVed <br /> <br />~r <br /> <br />Qwner's Name <br /> <br />ONner's Address <br /> <br />t.""" <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />Contractor <br />Signature <br /> <br /> <br />-t <br />ELECTRICIAN <br />Signature... ~ <br /> <br /> <br />-t <br />PLUMBER <br />Signature ~ <br /> <br /> <br />-t <br />MECHANICAL <br />Signature ~ <br /> <br /> <br />~-t <br />OTHER <br />Signature <br /> <br />Address _ 1;: <br /> <br />Directions: <br /> <br />8 <br />o <br />8 <br />o <br /> <br />-:- <br /> <br />J <br /> <br />Parcel # <br /> <br />o <br />8 <br />o <br />B <br />o <br />8 <br />o <br />8 <br />[ <br /> <br />City of Zephyrhills Fire' ~ 0 t 3~ <br />Pennit Application fI <br /> <br />Fax-813-7S0-0021 <br /> <br />Fee Simple TItleholder Name <br />Fee Simple Trtleholder Address <br /> <br />[ <br />[ <br /> <br />E J <br />.. <'l'6..,,, -\ '( ~Q.U) ~~u...." <br />.60?>'\ \ <>"'1 S\ <br /> <br />t <br /> <br />Bia-Hazard Waste Storage _ANNUAL <br /> <br />Comm Exhaust Kitchen Hood/DlJCl <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br /> <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~~~~ <br />Sprinkler 0 0 DOL-=' <br /> <br />Fire A1ann 0 0 0 0 c::J <br /> <br />Hood Cleaning ~~~ 0 0 0 ~ <br /> <br />Hood Suppression 0 0 0 0 CJ <br /> <br />Fire Alann Installation <br /> <br />'Fire Pumps <br />Fire Works <br />Aammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br /> <br />- <br /> <br />~ -:~,",-lJ[- 7f. <br />= Qwner'sPhoneN~ l /: 11S<i.; L"1~') 0 <br />7 ...4~~~"'\\\.~~ ~ :,- - : <br />"1----"\ lr ][ · <br /> <br />ii i - -= <br /> <br />-~~. [~ <br /> <br />[ <br /> <br />Fumigation Tent <br />HazardOUS Material (TIer 11 or RQ Facility) ANNUAL <br />Hood Installation <br />lP/Natufal Gas-lnstallatlon <br />LPfNatur81 Gas-ANNUAL Sale <br />PlaCeS of Assemb\Y-ANNUAL <br /> <br />RecreatiOt'1BI Bum <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofinglTar Kettle <br />Waste TIre Storage ANNUAL <br /> <br />] Valuation of project <br /> <br />\ <br />\ <br />J <br /> <br />1 <br />~ <br /> <br />::: ~ Y/N J FeoCoomt T Y/Nr- <br /> <br />=- E Y/N J FeoCoomt I Y/Nr <br />~~# [ ] <br />=- t y/N r F_Coomt [ Y/N-r <br /> <br />== ~ Y/N r FeoCoomt r Y/N ;- <br /> <br />:..:::JY/N r F_Coomt 1 Y/Ni <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 eommencement 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 />