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<br />813-780-0020 <br /> <br />-=tt_ 8~ <br /> <br />Phone con~ct for Permit _llSL S <br /> <br />'I <br /> <br />",Date .Recei:~___"",L__..," <br /> <br />Wi l <br /> <br />City of Zephyrhills Fir€ <br />Permit Application <br /> <br />Fax-813-780-0021 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />r U,(QdJ ll~ffLJ <br />II II I <br />I <br />I <br />I <br />_c) <br /> <br />I <br />I <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br />I <br /> <br />~SimPle"::=tddress ~ <br /> <br />Job Address ., .1' 1/60 <br />Sub Division , <br /> <br />Fee Simple Titleholder Name <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />- Ze Ph~(~I\I~'; ~l- 1'J,3~41 <br /> <br />:J1 Parcel # <br />-"""~JJl ~~ <br /> <br />D <br />D <br /> <br />D Hood Installation <br /> <br />D <br />D <br />D <br /> <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D <br />D <br /> <br />G,a , I <br /> <br />&.vo . <br /> <br />._,II!.I____.r <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bic-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />, ~. y~~~ <br />Sprinkler [Ji 0 0 0 L--' <br /> <br />Fire Alarm ~ 0 }( 0 c=J <br /> <br />Do ooc=J <br /> <br />Doooc=J <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />Contractor <br /> <br />Signature <br /> <br />Address <br /> <br /> <br />c-P <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br /> <br />ELECTRICIANI <br />Signature <br /> <br />Address I <br /> <br />I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature <br /> <br />Address I <br /> <br />OTHER <br /> <br />Signature <br /> <br />Address 1_ <br /> <br />Directions: <br /> <br />i Lot# <br /> <br />-'1' ! <br /> <br />I <br /> <br />1J1Ililllll. 'Ill <br /> <br />~""""'-"'r1lr \!f f ~t <br /> <br />.... <br /> <br />rtIT~r i i/ <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />I <br />I <br /> <br />I Y/N <br />I <br /> <br />I Y/N <br />I <br /> <br />I Y/N <br />I <br /> <br />~ Y/N <br /> <br /> <br />'iI'l.~ .~- <br /> <br />Fee Current <br /> <br />a'~~/~ ~ <br />Y I N Fee Current Y I N <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N I <br />_.w._ ~. I <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 (htlp:llappraiser.pascogov.com) <br />