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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date Received 'Z �j Phone Contact for Permit
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<br /> Owner's Name (',5 'C ,�7�'2S Owner's Phone Number �� �� �
<br /> Owner's Address �f �,30 Z c� S J�
<br /> Fee Simple Titleholder Name Titleholder Phone Number � �� C�
<br /> Fee Simple Titleholder Address
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<br /> Job Address Lot# �
<br /> Sub Division Paroel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent y t fi ,
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier 11 or RQ Facility)ANNUAL
<br /> � Controlled Bum a Hood installation
<br /> � Emergency Generator<30 kw a LP/Natural Gas-Installation
<br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
<br /> ��Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL,
<br /> �y emi �n er y
<br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum ' � � � � r'
<br /> Fire Alarm � ❑ ❑ � � � Sparklers ! 1 I� f ,
<br /> � � � ; : �,..
<br /> Hood Cieaning ❑ ❑ ❑ Sprinkler System Installatio?�s � �,.e'
<br /> ....--.--.'.r
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm Installation � Toroh Roofing/Tar Kettle
<br /> � Fire Pumps a Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> aFlammable Application-ANNUAL � Valuation of Project
<br /> Fuel Tanks
<br /> Q Other:
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<br /> -�s ��=_��;����,;.F��.���:�
<br /> Contractor �_ � Company
<br /> Signature Registered /N Fee Current Y/N
<br /> Address License#
<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 /> DTHER
<br /> Company
<br /> 5ignature Registered Y/N Fee Current Y/N
<br /> Address
<br /> License#
<br />�irections:
<br /> Fill out application completely
<br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contrect 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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