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813-780-0020 Ciry of Zephyrhills Fire Fax-81 -780-0021 ;
<br /> � Permit Application / ,n (�u�—
<br /> ate Received � ��� � �� Phone Contact for Permit V ��' �Q�
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<br /> voner's Name ✓ i ��� Owner's Phone Number
<br /> tivner's Address y� (� - C(jL{f,l�C Uj� 2 �� � 3l�Q S`
<br /> ee Simple Titleholder Name -"'� Titleholder Phone Number C� � �
<br /> ee Simple Titleholder Address -�-^'
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<br />�b Address �a � /�'�� G.P�lT � G�5 rv � 3 G'� Lot# �
<br /> ub Division Parcel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL � FumigaUon 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 /> � Emergency Generator>30 kw a LP/Natural Gas-ANNUAL Sale
<br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
<br /> �y emi �n er
<br /> Sprinkler � ❑ � ❑ B � Recreational Bum �-
<br /> Fire Alarm O ❑ ❑ � � Sparklers ��
<br /> / �
<br /> Hood Cleaning ❑ � ❑ � � Sprinkler System Installations ��
<br /> Hood Suppre�sion � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> Fire Alarm Installation J � Torch Roofing/Tar Kettle
<br /> �,___,--��.___
<br /> Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � Flammabie Application-ANNUAL � Valuation of Project
<br /> Fuel Tanks
<br /> ,� Q Other:
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<br /> ontractor Company �- �, ,
<br /> ignature � Registered Y N Fee Current Y/N
<br /> Address
<br /> License#
<br /> LECTRICIAN Company
<br /> ignature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> LUMBER
<br /> Company
<br /> ignature Registered Y/N Fee Current Y/N
<br /> Address License# �—
<br /> IECHANICAL Company
<br /> ignature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> THER
<br /> Company
<br /> ignature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> irections:
<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(http://appraiser.pascogov.com)
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