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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> °' Permit Application
<br /> Date Received � Phone Contact for Pertnit /3 7„$�9
<br /> , . . .. . . .. . ... .. .. . : . - ,. ,� .. . .. .,..�.� � . 83°�
<br /> Owner's Name O � ,S' Owner's Phone Number �� ��
<br /> Owner's Address �,,,
<br /> Fee Simple Titleholder Name TiUeholder Phone Number �� �
<br /> Fee Simple Titleholder Address
<br /> . . �;».-.�: .:�;z.ras.�°.,s�s�«=°;:�u>' .:�>. ��;�,:- . , � - �..�°... ,,-.,�.�H ,
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<br /> Job Address Lot # �
<br /> Sub Division Parcei #
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<br /> � - . "t . . ..z�t rz:.i<....,..a. .. , , �„ .. .,
<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 Instaltation
<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 �� /J
<br /> �y emi �n er /
<br /> Sprinkler � ❑ �� � Recreational Bum I�
<br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers �
<br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys)
<br /> � Fire Alartn Installation � Torch RoofingfTar 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 .S L �
<br /> Signature Registered Y/ N Fce 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 License #
<br /> MECHANICAL Company
<br /> Signature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> OTHER
<br /> Company
<br /> Signature Registered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> �Directions: . , � .. . .. n ,. _ . .. , .. ,. .. . .. . , . ..
<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 (httpJ/appraiser.pascogov.com)
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