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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date Received liaari Phone Contact for Permit
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<br /> Owner's Name r e i i - e 7 etc- Owner's Phone Number 1,r,t3 12r Iss//
<br /> Owner's Address Z 4. 6.044... Rza6. zpv.( ,cz,
<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 /> ri Controlled Bum n1 Hood Installation
<br /> r - 7 Emergency Generator < 30 kw ri LP/Natural Gas-Installation
<br /> El Emergency Generator > 30 kw n LP/Natural Gas-ANNUAL Sale
<br /> I - 1 Fire Protection Maintenance - ANNUAL 1 Places of Assembly-ANNUAL
<br /> Klitrlyl !Semi I'M' Other
<br /> Sprinkler IT 0 0 0 7 Recreational Bum
<br /> Fire Alarm TI 0 0 0 I I 7 Sparklers
<br /> Hood Cleaning ri 0 0 0 I I El Sprinkler System Installations
<br /> Hood Suppression [i0 0 IN 0 1 I I Standpipes (Sprinkler Sys)
<br /> ri Fire Alarm Installation ni Torch Roofing/Tar Kettle
<br /> 1 Fire Pumps I I Waste Tire Storage ANNUAL
<br /> n Fire Works
<br /> ri Flammable Application- ANNUAL
<br /> 1 I Valuation of Project
<br /> F1 Fuel Tanks
<br /> LI Other I
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<br /> Contractor Company
<br /> Signature Registered Y / N I Fee Current I Y / N . 1
<br /> Address I License #
<br /> ELECTRICIAN Company
<br /> Signature I Registered Y / N . 1 Fee Current I Y / N ,I
<br /> Address I License #
<br /> PLUMBER Company
<br /> Signature Registered Y / N I Fee Current I Y / N I
<br /> Address I
<br /> I License #
<br /> MECHANICAL Company
<br /> Signature Registered Y / N I Fee Current I Y / N I
<br /> Address I
<br /> I License #
<br /> ..
<br /> OTHER ,..---- . Company , Ar Z. - Ceel/ ' T
<br /> Signature ... Registered Iriallgi Fee Current Num
<br /> Address 1 License # I 2994,57-04/96//fx..
<br /> ,, .555 .
<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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