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813-780-0020 City of Zephyrhills Fire Fax-813-780-002
<br /> - Permit Application
<br /> � 9y Q �943
<br /> Date Received t� � �� Phone Contact for Permit �,Q Z
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<br /> Owner's Name /r�� r /L eT�+l��S Owner'S Phone Number �7 7d ,� jQV�
<br /> Owner's Address (Q ��/+ �7�y n �y� /T�L` ' �(. 3� � y i–
<br /> Fee S�mple Titleholder Name Titlehoider Phone Number C� C] �
<br /> Fee S�mpie Titleholtler Address
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<br /> Job Address C./ �J � �/� y � �'��l.G � /�(� �f S � Lot # ��
<br /> Sub Division Parcel #
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<br /> � Bio-Hazard Waste Storage - ANNUAL � Hazardous Material (Tier il or RQ Facility) ANNUAL
<br /> � Comm Exhaust Kitchen Hood/Dud a Hood Instaliation
<br /> � Controlled Bum � LP/Naturai Gas-Instaliation
<br /> � Emergenq Generator < 30 kw a LP/Natural Gas-ANNUAL Sale
<br /> � Emergency Generator> 30 kw � Places of Assembly-AI�NUAL
<br /> � Fire Protection Maintenance - ANNUAL a Recreational Burn
<br /> tr emi �n t er
<br /> Sprinkler � ❑ ❑ � � � Sparkiers
<br /> Fire Alarm �❑ ❑ �� � Sprinkler System Instailations
<br /> Hood Cleaning � O O �� � Standpipes (Spnnkler Sys)
<br /> Hood Suppression �❑ ❑ O� � Torch RoofinglT'ar Kettle
<br /> � Fire Alarm installatlon a Waste Tire Storage ANNUA�
<br /> � Fre F�mps
<br /> Fire Works
<br /> � Flammable Application- ANNUAI Valuation of Project
<br /> � fuel Tanks
<br /> � Other�
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<br /> Contractor COmpany ""T' .}, � (u �•D nG. I
<br /> Signature Registered Y/ N Fee Current Y I N
<br /> Address 3531 1�e ��anQ. Ra�. License# E,FOOOO
<br /> ELECTRICIAN Company � _
<br /> Signature RegiStered Y/ N Fee Current Y/ N
<br /> Address License #
<br /> PLUMBER Company
<br /> S�gnature Registered L Y/ N Fee Current Y/ N
<br /> adaress License #
<br /> MECHANICAL COmpany — �
<br /> Signature Registered Y/ N Fee Currznt Y/ N
<br /> Address License #
<br /> OTHER Company —�
<br /> Signature Registered Y/ N Fee Current Y! N
<br /> Address �—
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<br /> License #
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<br /> Di rect�ons: ' , _.-_..... ..___ �:-:: _._... .,
<br /> Fill out application completey
<br /> Owner 8 ConVactor 5ign back of applicaUon, notarized (Or, copy of signed contract with owner)
<br /> if over S2500, a Notice of Commencement is required (MeChanical work over 55000)
<br /> Supply lwo (2) sets of drawings with appiicabte documentation
<br /> Allow t 0-14 days for review after submittal date. Parcel #- obtained from Propsrty Tax Notice (http:Uappraiser pasCOgov com)
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