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sisaao-oozo City of Zephyrhills Fire Fax-e�saao-ooz�
<br /> Permit Application
<br /> �ate Received ` f ,3 J ) nI ,�—� �
<br /> Phone Contact for Permit �,! )��- Q
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<br /> Owner's Name /N Owner's Phone Number ��'��� ��
<br /> Owner's Address �' 7 SZ �
<br /> Fee Simple Titleholder Name Titleholder Phone Number �� ��
<br /> Fee Simple Titleholder Address
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<br /> Job Address �� �' �/ � ^ * P' � � Lot # � ��
<br /> Sub Division Parcel #
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<br /> � Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent
<br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Matenal (Tier II or RQ Facility) ANNUAL
<br /> Controlled Bum � Hood Installation
<br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation
<br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale
<br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL
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<br /> Sprinkler � ❑ ❑ ❑ � Recreational Burn
<br /> Fire Alarm � ❑ ❑ ❑ �� � Sparklers
<br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations
<br /> Hood Suppression � ❑ ❑ � � Standpipes (5prinkler Sys)
<br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> Fire Works
<br /> � Flammable Appiication- ANNUAL I� Valuation of Project
<br /> Fuel Tanks
<br /> Q Other:
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<br /> Contrector � � Company � /2,G � ' �
<br /> Signature � Registered N Fee rrent Y/ N
<br /> Address
<br /> �icense # j 3 g
<br /> ELECTRICIAN Company
<br /> Signature Registered Y/ N Fee Current Y/ N
<br /> Address
<br /> License #
<br /> PLUMBER
<br /> Company
<br /> Signature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> MECHANICAL Company
<br /> Signature Registered Y/ N Fee Current Y/ N
<br /> Address
<br /> License #
<br /> OTHER
<br /> Company
<br /> Signature Registered Y/ N Fee Current Y/ N
<br /> Address License #
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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 $50D0)
<br /> Supply iwo (2) sets of drawings with applicable documentation
<br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from PropeAy Tax Notice (http://appraiser.pascogov.com)
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