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a�a-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date Received Phone Contact for Permit � � ��
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<br /> Owner's Name a Owner's Phone Number "1� Z..
<br /> Owner's Address S �.5. !�.
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titieholder Address
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<br /> Job Address i , `� . Lot# �
<br /> iws� n �j( 'Z, • Parcel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> � Controlled Bum � Hood installation
<br /> aEmergency Generator<30 kw � LP/Natural Gas-Installation
<br /> nEmergency Generator>30 kw � LPlNatura�Gas-ANNJAL Sale
<br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
<br /> try emi � er �
<br /> Sprinkier � ❑ ❑ ❑ B � Recreational Bum r y���
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers i If
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<br /> Hood Cleaning l/� D D � � Sprinkler System Installations
<br /> Hood Suppression � ❑ ❑ O � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm Installation � Torch RoofinglTar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � Flammable Application-ANNUAL Valuation of Project
<br /> � Fuei Tanks
<br /> Q Other:
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<br /> Contract Company
<br /> .
<br /> Signature Registered Y/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/Iv Fee Current Y i�I
<br /> Address License#
<br /> MECHANICAL Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address
<br /> License#
<br /> OTHER
<br /> Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address license#
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<br /> Directions:
<br /> Fitl out application completely.
<br /> Owner&Contractor sign back of apptication,notarized(Or,copy of signed contract with owner)
<br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000)
<br /> Suppiy 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:!lappraiser.pascogov.com)
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