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<br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIANI <br /> <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address <br /> <br />Directions: <br /> <br />813-780-0020 <br /> <br />City of Zephyrhills Fire. <br />Permit Application <br /> <br /> <br />11 1', {' \- V' 0 \f"' <br />sJ ~w <br /> <br />'^ <br /> <br /> <br />1f ~O~6 <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br /> <br />Owner's Phone Number <br /> <br />Titleholder Phone Number I <br /> <br />II <br /> <br />II <br /> <br />_._-~-=-'II_m'@[ulIi_'J .~ <br /> <br /> <br /> <br />~~e~~_. ~l~~]i~. u <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />o <br />o <br />o <br />D <br />D <br /> <br />Fee Simple Titleholder Name ! <br />Fee Simple Titleholder Address I <br /> <br />I b't s7G~,;'._- <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~~~~ <br />Sprinkler 0 0 0 0 L-J <br /> <br />Fire Alarm 0 0 0 0 [=:=J <br /> <br />Hood Cleaning 0 0 0 0 [=:=J <br /> <br />Hood Suppression 0 0 0 0 [=:=J <br /> <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />~ <br />D <br />I <br /> <br />Fuel Tanks <br /> <br /> <br />1,(/ <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> <br />Hood Installation <br /> <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br /> <br />Places of Assembly-ANNUAL f1:l J _ r. r -f~., . I "I I. <br /> <br />Recreational Bum \..V J.JL~ "- MhJ~. ~ <br /> <br />Sparklers <br /> <br />Sprinkler System Installations rZ} 1-1 ~~;' Cd){.~ <br /> <br />Standpipes (Sprinkler Sys) \.Y <br /> <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />I i.?-I foou <br /> <br />Valuation of Project <br /> <br />Other: <br /> <br />ld-U;'t)if uV'n.t J1 f1~ IT <br /> <br /> ii.llljj~:~sm~L <br />Company IA((,{ 10\ itr (\ ~\r ( <br />Registered Y I N Fee Current I <br />License # I <br />Company I <br />Registered Y/N Fee Current <br />License # I <br />Company I <br />Registered Y/N Fee Current <br />License # I <br />Company I <br />Registered Y/N Fee Current <br />License # I <br />Company I <br />Registered Y/N Fee Current <br />License # <br /> <br />...,.~--~ II <br /> <br />SPt',V1 \,", \ [,r 5 <br />Y I N I <br />I <br /> <br />Y I N I <br />I <br /> <br />iJ <br />I <br /> <br />Y/N <br /> <br />Y/N <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 />