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813-780-0020 City of Zephyrhills Fire
<br /> Fax-813-780-0021
<br /> Permit Application
<br /> Date Received
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<br /> Ow�er's Name r�c � � �
<br /> � Owner's Phone Number
<br /> Owner's Address ��1 ,�nn e� q� �� (f� i ry C� F( 3 j
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<br /> Fee Simple Titleholder Name ` �� � ��
<br /> Titleholde hone Nurr,ther
<br /> Fee Simple Titleholder Address "°'� �
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<br /> Job Address � �
<br /> .LOt�#
<br /> Sub Division
<br /> Paroel# �
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<br /> Bio-Hazard Waste Storage-ANNUAL �
<br /> � Fumigation Tent �'
<br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or Facility) ��Uq�
<br /> � Controlied Burn Hood Installation
<br /> aEmergency Generator<30 kw a �_
<br /> � LP/Natural Gas-Installation
<br /> Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale �� � �
<br /> aFire Protection Maintenance-ANNUAL � ���� '
<br /> Places of Assembly-ANNUAL "1�
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<br /> Sprinkler ❑ ❑ ❑ � � Recreational Bum . jti� �
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<br /> Fire Alarm �
<br /> � � � � � Sparklers � �� .�
<br /> Hood Cleaning 0 � y� � �
<br /> � C� � Sprinkler System Installations C �i.
<br /> Hood Suppression ❑ � ❑ - O �f" ,
<br /> � � Standpipes(Sprinkler Sys) 1 �� i
<br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle j
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works �
<br /> � Flammable Application-ANNUAL �
<br /> a Valuationbf-Pro]'ect �
<br /> Fuel Tanks
<br /> Q Other:
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<br /> Contractor /f ° ..m�,,�
<br /> 5ignature /' Company ,
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<br /> Registered Y/N Fee Curr t Y/N
<br /> Address
<br />=LECTRICIAN License#
<br /> iignature Company
<br /> Registered Y/N Fee Current Y/N
<br /> Address
<br />'LUMBER License#
<br />�ignature Company
<br /> Registered Y/N Fee Current Y/N
<br /> Address
<br /> 1ECHANICAL License#
<br /> ignature Company
<br /> Registered Y/N Fee Current Y/N
<br /> Address
<br /> License#
<br /> THER
<br /> gnature Company
<br /> Registered Y/N Fee Current Y/N
<br /> Address
<br /> rections License#
<br /> Fill out application completely
<br /> Owner&Contractor sig�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 htt //a
<br /> ( p: ppraiser.pascogov.com)
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