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<br />813-780-0020
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<br />Date Recei9ed . J
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Name
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<br />Fax-813-780-0021
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<br />City of Zephyrhills 'Fire
<br />Permit Application
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<br />I ANDERSON PRESSURE r.r .F.ANThl; I
<br />i 5104 MURRAY ~~ DRrTAMPA.,Fr..11~1l)-4714
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<br />Fee Simple TItleholder Address
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<br />IGOLDEN CORRAL 6855 GALL BLVD. .ZEP~LS.FL.33542-2'57~
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<br />. _ Parcel # I
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<br />Contractor
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<br />Address I
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<br />ElECTRICIANI
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<br />Address I
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<br />PLUMBER I
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<br />Signature
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<br />Address I
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<br />MECHANICALI
<br />Signature
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<br />Address I
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<br />BiD-Hazard Waste Storage - ANNUAL
<br />Comm Exhaust Kitchen HoodIDuct
<br />Controlled Bum
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<br />Emergency Generator < 30 kw
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<br />Emergency Generator> 30 kw
<br />Fire Protection Maintenance - ANNUAL
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<br />Sprinkler
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<br />Fire Alarm
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<br />Hood Cleaning
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<br />Hood Suppression
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<br />Fire Pumps
<br />Fire Works
<br />Flammable Application- ANNUAL
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<br />Owner's Phone Number
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<br />Fumigation Tent
<br />Hazardous Material (Tier II or RQ Facility) ANNUAL
<br />Hood Installation
<br />LPlNatural Gas-Installation
<br />LPtNatural Gas-ANNUAL Sale
<br />Places of Assembly-ANNUAL
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<br />Recreational Bum
<br />Sparklers
<br />Sprinkler System Installations
<br />Stanclpipes (Sprinkler Sys)
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<br />Torch RoofingfTar Kettle
<br />Waste Tire Storage ANNUAL
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<br />Valuation of Project
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<br />Company
<br />Registered
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<br />Fee Current I
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<br />Y/N I
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<br />Y/N
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<br />Ucense #
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<br />Registered Y/N I Fee Current .1 Y/N
<br />Ucense #
<br />Company
<br />Registered Y/N I Fee Current Y/N
<br />Ucense #
<br />Company
<br />Registered Y/N I Fee Current I Y/N
<br />Ucense #
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<br />OTHER
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<br />Signature
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<br />Address j
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<br />Directions:
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<br />Company
<br />Registered Y I N I Fee Current Y I N
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<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 appliceble documentation
<br />Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.;om)
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