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. a�aaso-oozo City of Zephyrhills Fir� Fax-s�s-7so-oo2i
<br /> Permit Application __
<br /> Date Received Z. � � Phone Contact for Permit {'� � �u
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<br /> Owner's Name Owner's Phone Number � � �
<br /> Owner's Address
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address
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<br /> Job Address �'N � Lot# ��
<br /> Sub Division Paroel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or Rl�Facility)ANNUAL
<br /> � Controlled Bum � Hood Installation
<br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation
<br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale
<br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
<br /> r y emi �n er /� � �/
<br /> I 1 `r
<br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum 2 i
<br /> Fire Alartn � ❑ ❑ � � � Sparklers
<br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
<br /> Hood Suppression � ❑ ❑ ❑ �� � Standpipes(Sprinkler Sys)
<br /> � Fire Alartn Installation � Torch RoofinglTar Kettle
<br /> � Fire Pumps � �Naste Tire Storage ANNUAL
<br /> Fire Works
<br /> � Flammable Application-ANNUAL , "" Valuation of Project
<br /> Fuel Tanks
<br /> Q Other: ' S � fI�^
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<br /> Contractor � Company '�1'Q-t� ! �t'� v
<br /> Signature Registered /N Fee Current Y/N
<br /> Address License# '�j�0 O�O
<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 Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
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<br /> Directions:
<br /> Fili 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:/Jappreiser.pascogov.com)
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