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<br />813-780-0020 ( J City ofZephyrhills Fire Fax-813-780-0021
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<br />Fee Simple TltIeholder Name I I TItleholder Phone Number I II II
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<br />I I Lot# I
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<br />Owner's Name
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<br />Owner's Address
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<br />Job Address
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<br />Fumigation Tent
<br />Hazardous Material (Tier 11 or RQ Facility) ANNUAL
<br />Hood Installation
<br />LP/Natu'al Gas-Installation
<br />LPINaturaI Gas-ANNUAL Sale
<br />Places of Assembly-ANNUAL
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<br />Bio-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 />Recreational Bum
<br />Sparklers
<br />Sprinkler System Installations
<br />Standpipes (Sprinkler Sys)
<br />Torch Roofing/Tar Kettle
<br />Waste Tire Storage ANNUAL
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<br />Sprinkler
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<br />Fire A1ann
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<br />Hood Cleaning
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<br />Hood Suppression
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<br />D Rre A1ann Installation
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<br />D Fuel Tanks
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<br />Fire Pumps
<br />Rre Works
<br />Flammable Application- ANNUAL
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<br />Valuation of Project
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<br />Company
<br />Registered Y INI Fee Current I Y/N
<br />Ucense #
<br />Company
<br />RegIstered Y/N I Fee Current I Y/N
<br />License #
<br />Company
<br />Registered Y/N I Fee current I Y/N
<br />Ucense #
<br />Company
<br />Registered Y/N I Fee Current Y/N
<br />license #
<br />Company
<br />Registered
<br />Ucense #
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<br />Contractor
<br />Signature
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<br />Address I
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<br />ELECTRICIAj
<br />Signature
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<br />Address I
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<br />PLUMBER
<br />Signature
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<br />Address I
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<br />MECHANICALI
<br />Signature
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<br />Address I
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<br />OTHER
<br />Signature
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<br />Address
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<br />RII 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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