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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> , Permit Application
<br /> �ate Received _ • �� Phone Contact for Permit
<br /> _ _ � � _ .,,��a�„�r. -._ .. _, _,..,..�.�.-,a,�..r.-,_.r,-.,,.::. , _
<br /> Jwner's Name L✓� Z/�'! /•i/�-% (] (� Owner's Phone Number �� �
<br /> �wner's Address �- �
<br /> =ee Simple Titleholder Name Titleholder Phone Number �� �
<br /> =ee Simple Titleholder Address
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<br /> lob Address Lot # �
<br /> 3ub Division Paroel #
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<br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct Q Hazardous Material (Tier II or RQ Facility) ANNUAL
<br /> a Controlled Bum � Hood Installation
<br /> � Emergency Generator < 30 kw � LP/Natural Gas-I�statlation
<br /> � Emergency Generator > 30 kw � lP/Natural Gas-ANNUAL Sale
<br /> � Fire Protection Maintenance - ANNt1AL � Places of Assembly-ANNUAL
<br /> �y emi n er � '�',` .J
<br /> Sprinkler ❑ ❑ � � � Recreational Bum � �
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<br /> Fire Alarm ❑ ❑ ❑ � � Sparklers
<br /> Hood Cleaning � ❑ O ❑� � Sprinkler System Installations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys)
<br /> a Fire Alarm Installation � Torch Roofing/Tar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � Flammable Application- ANNUAL Valuation of Project
<br /> � Fuel Tanks
<br /> Q Other:
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<br /> �ntractor Company
<br /> 5ignature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> ELECTRICIAN Company
<br /> 5ignature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> PLUMBER Company
<br /> 5ignature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> NECHANICAL Company
<br /> 5ignature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> JTHER Company
<br /> 3ignature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> �irections:
<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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