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813 -780 -0020 City of Zephyrhills Fire Fax - 813-780 -0021
<br /> Permit Application
<br /> Date Received t Phone Contact for
<br /> Permit I
<br /> Owner's Name AeLeA" �5 IgQ, & st / evil) Tip ` Owner's Phone Number I
<br /> Owner's Address 366 f `L e i
<br /> Fee Simple Titleholder Name Titleholder Phone Number
<br /> Fee Simple Titleholder Address
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<br /> Job Address Lot #
<br /> Sub Division Parcel #
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<br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent
<br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL
<br /> n Controlled Bum Hood Installation
<br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation
<br /> n Emergency Generator> 30 kw LP /Natural Gas - ANNUAL Sale
<br /> El Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL
<br /> [aryl I Semi I Frill Other
<br /> Sprinkler n ❑ ❑ ❑ ( f Recreational Bum
<br /> Fire Alarm n ❑ ❑ ❑ I n Sparklers
<br /> Hood Cleaning n ❑ ❑ ❑ I 1 n Sprinkler System Installations
<br /> Hood Suppression n ❑ ❑ ❑ I I I I Standpipes (Sprinkler Sys)
<br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle
<br /> I Fire Pumps I Waste Tire Storage ANNUAL
<br /> Fire Works
<br /> n Flammable Application- ANNUAL 1 Valuation of Project
<br /> F Fuel Tanks
<br /> Other: I
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<br /> Contractor Company
<br /> Signature Cruet, Registered Y / N , Fee Current 1 Y / N 1
<br /> Address License #
<br /> ELECTRICIAN Company
<br /> Signature Registered Y/ N I Fee Current I Y/ N I
<br /> Address I License #
<br /> PLUMBER Company
<br /> Signature Registered Y/ N I Fee Current I Y / N
<br /> Address I I License #
<br /> MECHANICAL Company
<br /> Signature Registered Y/ N I Fee Current I Y/ N j
<br /> Address I License #
<br /> OTHER Company
<br /> Signature Registered Y/ N I Fee Current I Y/ N
<br /> Address j I 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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