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<br />813-780-0020 <br /> <br />Date Received <br /> <br />~,~3!1~~ <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />City of Zephyrhills Fi~. . ~/ e ( ~ '1/ <br />Permit Application 1X' <br /> <br />.. <br /> <br />1 ~. r <br /> <br />T I <br />~....;\ \ue<l~t) ~ (~ <br />--; l 0 ~ '-\: \ t. \\.\.\0 V\~ 'i)il- <br />I .~ bfj~ <br />1 <br /> <br />Fee Simple TItleholder Name <br />Fee Simple llt1eholder Address <br /> <br />Contractor <br />Signature <br /> <br />Address <br /> <br />ELECTRICIANI <br />Signature <br /> <br />Address I <br /> <br />PLUMBER I <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address I <br />__ I;;; - -IT <br />Directions: <br /> <br />W'~.~r <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />~"'-,-- <br /> <br />f~ <br />I <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bla-Hazard Waste Storage -ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br />Emergency Generator < 30 kw <br /> <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />. [9!!!) ~.~ ~ <br />OoooL-J <br />Ooooc=J <br />~ ~ ~ ~ B <br /> <br />Fax-813-780-0021 <br /> <br />:~ <br /> <br />Pho~ Contact for Permit t- U 1J <br />I Owner's Phone Number .~ -115~ I -, <br />7 4~\\~'^\\\~ \ ~ <br />I Titleholder Phone Number I <br /> <br />I <br />, <br /> <br />\"t'l...S I <br /> <br />I <br />I <br />i <br />I <br /> <br />Sprinkler <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Aammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />II <br /> <br />II <br /> <br />I Lot# <br /> <br />Parcel # <br /> <br />o <br />o <br />o <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />~ <br /> <br />Fumigation Tent <br />Hazardous MaterIal (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LPlNatural Gas-lnstallation <br />LPlNatural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br />Spar1<1ers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofinglTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />I Valuation of Project <br /> <br /> Company <br /> Registered Y/N I Fee Current I Y/N <br /> License # <br /> - <br /> Company <br /> Registered Y/N I Fee Current I Y1N I <br /> License # I <br /> Company <br /> Registered Y/N I Fee CUrrent I Y/N I <br /> License # I <br /> Company <br /> Registered Y/N I Fee Current I Y/N I <br /> License # I <br /> Company <br /> Registered Y/N I Fee Current I Y/N I <br />,J License # J <br /> ...........---~ <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 Con1mencement Is reqirired(Mechanlcal work over $50(0) <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 (htIp://appraiser.pascogov.com) <br />