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ati�-�saoo2o City of Zephyrhills Fire �ax-813-780-0021
<br /> Permit Appiication
<br /> .
<br /> Date Received �
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<br /> Phone Contact for Permit
<br /> —____------ ---- ' ---- ---- �. .-�---
<br /> Owners Name Ownets Phone Number � �
<br /> Owner's Address �`i'- {
<br /> Fee Simple Tilleholder Name Titlehofder Phone Nurober � � C�
<br /> Fee Simple TitlehoEder Address
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<br /> Su8 Division Percel#
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<br /> � B1aHazard Waste StoraBe-ANNUAL Q Fumigation Tent
<br /> a Comm Exhaust Kitchen HaodlDucl � Hazardous Materiat(Tier II or RQ Fadlity)ANNUAL
<br /> a ConVolled Burn � Hood Ins[alla6on
<br /> QEmergency Generaior<30 kw � LPMatural Gas-Installation
<br /> QEmergency Generator>30 kw Q LPINalural Gas-ANNl3AL Sale
<br /> � Fire Protedion Mafntenance-ANNUAL a Places of Assembly-ANNUA� �
<br /> � em � er �,t
<br /> Sprinkier � �~ ❑ � � � Recreational Bum ��v
<br /> Fire Atarm � ❑ ❑ � � � Sparkiers
<br /> Hood Cleaning � O d O � � Sprinkler System InstallaGons
<br /> Hood Suppression � O ❑ o � � Standpipes(Sprinkier Sys)
<br /> � Fire Aterm Installation � Tarch Roofinglfar Ketde
<br /> � Fira Pumps � Waste Tire 5torage ANNUAL
<br /> � Fire Works
<br /> � Flammable Appiica6on-ANNUAL �_—� Valuation af Project
<br /> � Fuet Tanks
<br /> Q Oth@r:
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<br /> ConVaGor Company � � �
<br /> Signatute � Registered Y/ Eee Currenl Y 1 N
<br /> Address i.icense#
<br /> E�ECTRICIAN Company
<br /> Signature � Registered Y/N Fee Current Y/N
<br /> Address License tf �
<br /> PLUMBER Company
<br /> Signature Regislered Y 1(�l Fee Curcent Y/N
<br /> Address License#
<br /> MECHANICA Company
<br /> Sigaeture Registerei! Y/N Fee Current Y/N
<br /> Address License#
<br /> OTHER Company r
<br /> Signature Registered Y/N �ee Current Y/N
<br /> Address License# �
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<br /> Directiuns:
<br /> FiiE ouf application compleiely.
<br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with rnmer)
<br /> If over$25Q0,a Nolice of Commenoement is required(Mechanical woric over$5pD0)
<br /> Supply two(2y sets of drawings with applicaDle documentaUort
<br /> Atlow 40-74 days for review after submittal date. Parcei#-obtained from Property"fax Notice(http:!/appraiser.pasoogov.com)
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