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813-780-0020 Clty�of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
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<br /> DatE Received��Y�_J ^� �`� T_����� __ i ,� �_� Phone Contact for Permit`�_�,�
<br /> �ets Name ,� h��S Owner's Phone Number � `7��j �/Q�j
<br /> ers Address '7 j f (�j, d � � I �� � ��i�.
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<br /> Fee Simple Titleholder Name ; Titleholder Phone Number
<br /> Fee Simple Titleholder Address '
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<br /> Job Address i a Y Lot# �
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<br /> Sub Division � Parcel#
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<br /> � �Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent
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<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> � Controlled Bum � � Hood Installation
<br /> � Emergency Generator<30 kw � � LP/Natural Gas-installation
<br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
<br /> � Fire Protection Maintenance-ANNUAL n Places of Assembly-ANNUAL� �7/U17/� v�uY�
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<br /> try emi �n t er
<br /> Sprinkler � ❑ ❑ ❑ � Recreational Burn
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers
<br /> Hood Cleaning � ❑ ❑ ❑ ;� � Sprinkler System Installations �/���
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<br /> Hood Suppression � ❑ ❑ ❑ �� � Standpipes(Sprinkler Sys) l
<br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle
<br /> � Fire Pumps i � Waste Tire Storage ANNUAL
<br /> � Fire Works !
<br /> � Flammable Application-ANNUAL ; Valuation of Project
<br /> � Fuel Tanks �
<br /> Q Other: �
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<br /> Contractor � � Company
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<br /> ig ature , 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/N Fee Curcent Y/N
<br /> Address � License#
<br /> MECHANICAL Company
<br /> Signature � Registered Y/N Fee Current Y/N
<br /> Address j License#
<br /> OTHER � Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address � License#
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<br /> Directions: ..�-._____.,-_.__. �.�__.___ _�___._.__� __. ....__.,>_..,,_..._�.._.�.._�_..._._._,_.�.._.,
<br /> Fill out application completely. �
<br /> Owner 8 Contractor sign back of application,notarized(Or,cdpy 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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