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a� aaao-oo2o City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> �ate Received Phone Contact for Pertnit
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<br /> Jwner's Name Owner's Phone Number �� ��ds
<br /> �wner"s Address �! yO �� �
<br /> =ee Simple Titleholder Name Titleholder Phone Number �� �
<br /> =ee Simple Titleholder Address
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<br /> Job Address Lot # �
<br /> 5ub Division Parcel #
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<br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL
<br /> � Controlled Bum � Hood Installation
<br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation
<br /> a Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale
<br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL
<br /> � emi � er
<br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers
<br /> Hood Cleaning �❑ �Q ❑� � 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 /> Contractor Company
<br /> Signature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> ELECTRICIAN Company
<br /> Signature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> PLUMBER Company
<br /> Signature Registered Y/ N Fee Current Y/ N
<br /> Address Lice�se #
<br /> MECHANICAL Company
<br /> Signature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> OTHER Company v � � G G L
<br /> Signature Registered N Fee Current N
<br /> Address License # ,�P ,5`�QG�j
<br /> Directions:
<br /> Fill out application completely.
<br /> Owner & Co�tractor 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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