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813-780-0020 i City of Zephyrhills Fire � Fax-813-780-0021
<br /> , �� Permit Applicatian
<br /> Date Received �- _� Phon �'r�R��
<br /> e Contact for Perrnit j
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<br /> Owner's Name ��.... � �'e � Owner's Phone Number � �� �
<br /> Owner`s Address � cjt„'"� �,�� j p,1"`� ��.. 3a (�
<br /> Fee Simple Titleholder Name Tit(eholder Phone Number � � L�
<br /> Fee Simple Titlehoider Address
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<br /> Job Address ca�r Z� h h� ,5'�� � Lot# � ��
<br /> Sub Division Parcet# - —� - � �_ �� ��b
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<br /> � Bio-tiazard Waste Storage-ANNUAL ���Fumigation Tent � � �W�������
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> � Controiled Bum � Haod tnstatiation
<br /> � Emergency Generator<30 kw � LPMatural Gas-Installation
<br /> � Emergency Generator>3Q kw � LPlNatura!Gas-ANNUAL Sate
<br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
<br /> try emi A� t er ❑
<br /> Sprinkler ❑ ❑ �nj Recreational Bum
<br /> Fire Alarm � ❑ ❑ ❑ C� � Sparklers
<br /> Hood Cieaning � Q ❑ ❑ �� � Sprinkler System Installations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm Instaltation � Torcfi RoofingJTar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � Flammable Application-ANNUAL ��—� Valuation of Project
<br /> Fue1 Tanks
<br /> 0 Othef:
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<br /> Contrac r'� � Company�� hl r j f � �iv�, �'!1 C
<br /> Signat r � Registered N Fee Current Y/N
<br /> Address �`7 (� License# (��;� (,'p O�Ca
<br /> E�ECTRICIAN Campany �
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> PLUMBER Company —�
<br /> Signature Registered � Y/N � Fee Gurrent Y/N
<br /> Address License�
<br /> MECHANICAI Gompany ��
<br /> Signafure P.egisterzd Y f N Fee Current Y/N
<br /> Address License#
<br /> OTHER Company �� � �
<br /> Signature Registered Y(N Fee Gurre�t Y/{�! �
<br /> Address License#
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<br /> Directions:�.�.....,.._ w�. .�._.._...._ ._..�._a..>�_..��.,___._..�.�..��,_.w_.�._,...�...«...�.��.�.,�..._.��..w�..�_,_�._,...,v., ,�..�,u.�.,.."�..�:-
<br /> FiN out applioation comp(efely
<br /> Owner&Contractor sign back of appiication,notarized(Qr,copy of signed contract with owner)
<br /> tf over$2500,a Notice of Cammencement is required(Mechanical wor4c over�5000)
<br /> Suppty two(2)sets of drawings with appficabie documentation
<br /> Allow 10-'14 days for review after submittai date. Parcel#-obtained from Praperty Tax Notice(http://appraiser.pascogov.com)
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