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813- 780 -0020 City of Zephyrhills - Fire 1f 16 Fax - 813 - 780 -0021 .
<br /> Permit Application iiii���� CC
<br /> Date Received Phone Contact for Permit
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<br /> Owner Name L 14) A1 W o K Owner's Phone Number I
<br /> Owner's Address
<br /> Fee Simple Titleholder Name Titleholder Phone Number
<br /> Fee Simple - Titleholder Addre
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<br /> Sub Division Parcel #
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<br /> n Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent
<br /> I I Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
<br /> n Controlled Bum I I Hood Installation
<br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation
<br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale
<br /> 11 Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL
<br /> jutrlyI (Semi Other
<br /> 4
<br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum
<br /> Fire Alarm E ❑ ❑ ❑ I I ( 1 Sparklers
<br /> Hood Cleaning n ❑ ❑ ❑ I ( n Sprinkler System Installations /`� ITE31 U Hood Suppression ❑ K ❑ 1 I n Standpipes (Sprinkler Sys) �/
<br /> n Fire Alarm Installation 1 1 Torch Roofing/Tar Kettle
<br /> n Fire Pumps n Waste Tire Storage ANNUAL
<br /> n Fire Works
<br /> n Flammable Application- ANNUAL I I Valuation of Project
<br /> n Fuel Tanks
<br /> n Other: I
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<br /> Contractor Company
<br /> Signature Registered Y/ N I Fee Current I Y/ N I
<br /> Address I I License #
<br /> ELECTRICIAN Company
<br /> Signature Registered Y/ N j Fee Current I Y/ N
<br /> Address I ( License # I I
<br /> PLUMBER Company
<br /> Signature Registered Y/ N j Fee Current I Y/ N I
<br /> Address I
<br /> 1 License #
<br /> MECHANICAL Company
<br /> Signature Registered Y/ N J Fee Current 1 Y/ N
<br /> Address ( fif/1 I Li cense # I
<br /> OTHER Company CoIh/h1st c /4/ L € �d ii) J
<br /> Signature Registered Y / N Fee Current Y / N
<br /> Address p— Ig , r yass'ti License #
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<br /> Directions:
<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)
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