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<br />813-780-0020 <br /> <br />City of Zephyr hills Fir-€!' <br />Permit Application <br /> <br />Date Recei~ed <br /> <br />",J _"" '_''''''''',",,' ? <br /> <br />..-L <br /> <br />~t+~~_....,L <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fax-813-780-0021 <br /> <br />if lbQ21 <br />Pho~eContactf~rpe.rmit j ~l~ llW LJ,;;J" ~f' I <br />... t lIll. -', ~- 'Y,' _'----'-'----\'~-~ _-"i"",~_-_ ';iI"'Hi:S:', <br /> <br />II II I <br />I <br />I <br />I <br />?t!"=. <br /> <br /> <br />I <br /> <br />Owner's Phone Number <br /> <br />1 <br /> <br />I Titleholder Phone Number <br /> <br />II <br /> <br />II <br /> <br />I <br /> <br />Fee Simple Titleholder Address I <br /> <br /> <br />~P4~ <br /> <br />Fee Simple Titleholder Name <br /> <br />! It <br /> <br />&1 <br /> <br />,~ <br /> <br />I <br /> <br />Z.(~b ,FL <br />r ~~rcel # I <br /> <br />1I:lW_IlIIl~~1l1li'i1!!' :1idii~"f~l <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 />(~II <br /> <br />81vd. <br /> <br />Job Address <br /> <br />Sub Division <br />MIII!llIiln W1Wtl !III~ <br />D Bio-Hazard Waste Storage - ANNUAL <br /> <br />D <br />D <br />D <br />D <br />D <br /> <br />; ~ <br /> <br />ifU <br /> <br />_11l <br /> <br />~ <br /> <br />_lIim u <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~~~~ <br />lYIK. 0 0 L-J <br />Do ooc=J <br />Doooc=J <br />Doooc=J <br /> <br />Sprinkler <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br /> <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br />Fuel Tanks <br />Other: <br /> <br /> <br />Contractor <br />Signature <br />Address <br />ELECTRICIANI <br />Signature <br />Address I <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature . <br />Address I <br />OTHER <br />Signature <br />Address J,. w <br />Directions: <br /> <br />~. <br /> <br />e-P <br /> <br />T '1' <br /> <br />3 354 I <br /> <br />Lot # <br /> <br />~u!. G <br /> <br />'m~~t W <br /> <br />i!IIIill <br /> <br />~l'. <br /> <br />\, 1W'4i':rr"~ ' <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 />5,,""p/~ ~ <br />Y IN I Fee Current Y IN <br /> <br />Company <br />Registered <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />..J <br /> <br />Company <br />Registered Y I N <br /> <br />License # J~,,"--,><>,~~ .r- ~l <br /> <br />.~ c~'o <br /> <br />Fee Current <br /> <br />Y / N I <br /> <br /> <br />",.', "rJ <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 />