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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> � , • Permit Application � �.�
<br /> Date Rec�ived. ` Phone Contact for Permit � ` �'] � �( �
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<br /> Owner's Name ��, � � Owner's Phone Number � � �
<br /> Owner's Address L�� vY� Z.U� �..� (;a�'�'� � ���i „P�'F��l.l�Yl,q ���� 411v I�p2
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<br /> Fee Simple Titleholder Name � f Titieholder Phone Number
<br /> Fee Simple TitleholderAddress
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<br /> JobAddress ��� ��� z'ei �� s �,u '��� Lot# �
<br /> Sub Division 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 Burn � Hood Installation
<br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation
<br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
<br /> I � ,l � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
<br /> �t��J tr y emi �n t er. �<l�
<br /> I Sprinkler � ❑ ❑ ❑ � � Recreational Bum � ,� ' �
<br /> i Fire Alarm � ❑ O ❑ � � Sparklers ;�
<br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
<br /> Hood Suppression �� O � � � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm installation � Torch Roofing/Tar Kettie
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> Fire Works
<br /> � Flammable Application-ANNUAL Valuation of Project
<br /> � Fuel Tanks
<br /> 0 Other:
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<br /> Contractor � Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address �, � � License#
<br /> ELECTRICIAN 2 � �1 Company
<br /> Signature l�� �X�-Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> PLUMBER Company
<br /> Signature - Rec�istered 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 /> OTHER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
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<br /> Directions: , _�_.�ti_.,�.��_.___� �_.v._.�.�._v�._.�..�.v,.__._.�__.a_. ..,�.._..�.._....,_ ---�._.�..__......�_...
<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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