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813-780 -0020 City of Zephyrhills Fire /< I "" Fax- 813- 780 -0021
<br /> • - Permit Application
<br /> Date Received Phone Cont for Permit 7 1' `��
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<br /> Owner's Name 1 ZENµjRHILLS VonT OFF(CE." 1 Owner's Phone Number 18 I3 11786 I ( '77'0 I
<br /> Owner's Address 1 3 PoSrAL DR. Z E PNYRNILsc FL. 33 svr
<br /> Fee Simple Titleholder Name Titleholder Phone Number I I 1 1
<br /> Fee Simple Titleholder Address I
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<br /> Job Address 1 2 EPNYR N (Les PL. 337 V0 Lot#
<br /> Sub Division 1 C ITy OF ZEPµ ykuILLS' Parcel# I
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<br /> n Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL
<br /> n Comm Exhaust Kitchen Hood /Duct n Hood Installation
<br /> F C ontrolled Bum n LP /Natural Gas - Installation
<br /> I - 7 Emergency Generator < 30 kw = LP /Natural Gas - ANNUAL Sale
<br /> n Emergency Generator > 30 kw n Places of Assembly- ANNUAL
<br /> I - 7 Fire Protection Maintenance - ANNUAL LJ Recreational Burn
<br /> (Qtrly) Semi gm Other
<br /> Sprinkler ® ❑ ❑ X n Sparklers
<br /> Fire Alarm I ❑ ❑ ❑ ( I n Sprinkler System Installations
<br /> Hood Cleaning n ❑ ❑ ❑ I 1 n Standpipes (Sprinkler Sys)
<br /> Hood Suppression El ❑ ❑ ❑ I I n Torch Roofing/Tar Kettle
<br /> n F ire Alarm Installation = Waste Tire Storage ANNUAL
<br /> n F - ire Pumps
<br /> E1 Fire Works
<br /> 0 Flammable Application- ANNUAL
<br /> 1 I Valuation of Project
<br /> n F - uel Tanks
<br /> Q Other: I I
<br /> e.3`.3N§.3ab<4.�'.�iii a I:.; _e...1 <.<P . .1� 1 1..`i? ':•.�h $�<aR*Ra. u.-. e: . ' v' . M NAMI �' '3I.,I".E'$�.Av.M :E'er= ad g.. 'r`aT .<SZMIa ,`_ t :Vggi itAt ONMOMU z , IC','",. ::. ... ;,,,,
<br /> Contractor . Company ASAPAmhAru SPo. KlG►I A o 1'I Pr ,A.
<br /> Signature ' C ..,_ .. • 1 _ — Registered Y / N I Fee Current I Y / N I� ) 3
<br /> Address • . - St` C . _ i • - S License # ( I
<br /> ELECTRICIAN Company I
<br /> Signature Registered Y/ N I Fee Current I Y / N
<br /> Address I I License # ( I
<br /> PLUMBER Company I
<br /> Signature Registered Y/ N I Fee Current 1 Y/ N I
<br /> Address I I License # I
<br /> MECHANICAL Company I
<br /> Signature Registered Y / N I Fee Current I Y/ N I
<br /> Address ( I License # ( I
<br /> OTHER Company I
<br /> Signature Registered Y/ N I Fee Current I Y / N I
<br /> Address License #
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<br /> Directions:
<br /> Fit out application completely.
<br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner)
<br /> 1 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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