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<br />813-780-0020 <br /> <br />City of Zephyr hills Fir€' <br />Permit Application <br /> <br />-if tl)~ <br /> <br />Fax-813-780-0021 <br /> <br />.. Da~e Received ~ __J <br />#Y, . lJt}fj.~f<mr~, -----'.._.... "C',',' .-.,~ <br /> <br />Phorie Contact f~r p:':,'$~L,....."""" <br /> <br />,.,&..LL-.., <br /> <br />LL,__J <br />II I <br />I <br />I <br />, <br /> <br />..'U; <br /> <br />I <br />I <br /> <br />Owner's Name <br /> <br />Owner's Phone Number <br /> <br />I <br /> <br />II <br /> <br />Owner's Address <br /> <br />II <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address I <br />II: -1iL.._ <br /> <br />JobAdd~, ~114 <br /> <br />Sub Division C <br />lIIIl!ftUInl:l .___."" <br /> <br />Titleholder Phone Number I <br /> <br />II <br /> <br />~Jvrl1(/J~ I EL <br /> <br />__ Parcel # I <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 Torch RoofingfTar Kettle <br />D Waste Tire Storage ANNUAL <br /> <br />Ga J I <br /> <br />6' "d . <br /> <br />oW <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-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 />-r--I.~ ~ ~ ~ <br />~OD)(L-J <br />Do DOr==:J <br />Do DOr==:J <br />Do DOr==:J <br /> <br />Sprinkler <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />Contractor <br />Signature <br /> <br /> <br />c-P <br /> <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 />Address <br /> <br />ELECTRICIANI <br />Signature . <br /> <br />Address I <br /> <br />PLUMBER I <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature <br /> <br />Address I <br /> <br />OTHER <br /> <br />Signature <br /> <br />Address I <br /> <br />Directions: <br /> <br />~, "'1n~r <br /> <br />3] ~;:.j;wt <br /> <br />.T <br /> <br />I Lot# <br /> <br />~j__'IIiII <br /> <br />.1 It ill <br /> <br />'1iil <br /> <br />1J <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 />Valuation of Project <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />I <br />I <br /> <br />I Y IN <br />I <br /> <br />I Y/N I <br />I <br /> <br />I Y IN <br />I <br /> <br />I Y/N <br />L~.~~ <br /> <br />.f)'~~/<v ~ <br />Y I N Fee Current Y I N <br /> <br />Company <br />Registered <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />License # <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 <br /> <br />Fee Current <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Fee Current <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 (htlp:llappraiser.pascogov.com) <br />