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<br />813-780-0020 <br /> <br />~~~'~~~;~~~'~i~:~","".;;J<~, <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />City ofZephyrhillsFir.-e <br />Permit Application <br /> <br />I". ' .. d~,,~~~ne Contact for Permit J, . . ,1.1, U I <br />".,,,,,,~,,:,:;,~,.,,,,'''i'~;'~;:''''<\oi<l:''''''''''''')''''ic,.iM''',.:~U!Z~~~~R~"Mf.&~1'~Wji~If~~U:-"'''''''<~'''''''~~='''''~'':N_~,,,,,,,"1!!i4A_''''''''''''''''-""'+"::~,'~;~~~liO<."";';'!:;<:-;''I-'W_,,C'"':f:,'''''"'':;''' <br /> <br />'I g 1'1 1178 .21.18'.t~7 I <br />!1S'"lf '2 <br /> <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />D Fire Alarm Installation <br /> <br />B <br /> <br /> <br />El Fuel Tanks <br />o Other: I <br /> <br />"~~~I~~' <br /> <br /> <br />Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />o <br />o <br />D <br />D <br />D <br />o <br /> <br />ELECTRICIANI <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 />11110 <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 D 0 0 0 L-J <br />Fire Alarm D 0 0 0 c=J <br />Hood Cleaning D 0 0 0 c=J <br />Hood Suppression D 0 0 0 c=J <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Appiication- ANNUAL <br /> <br />-\:y~a7 <br /> <br />Fax-813-780-0021 <br /> <br />II <br /> <br />II <br /> <br />I <br /> <br />l. 2-;)0.. ()() L <br /> <br />D <br />D <br />D <br />D <br />~ <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br /> <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 /> <br />Ist'J ?< I~ <br /> <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing/Tar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />~~' <br /> <br />~ih..._IIm'.4. <br /> <br />r"""""'~llll!i'_--~' <br /> <br />Company <br />Registered Y I N I <br /> <br />_ license # <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />" '~t <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />license # <br /> <br />Company <br />Registered <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />license # <br /> <br />Company <br />Registered <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />license # <br /> <br />Company <br /> <br />Registered <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />=~ <br />Directions: <br /> <br />license # <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 />