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813-790-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> �o.. Permit Application
<br /> 6,
<br /> Date Received -•� PhoneLC�ontact for�Permit __�����
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<br /> Owner's Name V f �l �� Owner's Phone Number � � [�
<br /> Owner's Address I (�� �1 rl�v� �I� z ��-�-� �� J��
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address f
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<br /> Job Address �� 1 1 ���Y o��� e,� TY 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 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 � Places of Assembly-ANNUAL
<br /> r y emi �n t er
<br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers �rJs��
<br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations �,
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm Installation � Torch Roofing/Tar KetUe
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> FlammableApplication-ANNUAL Valuation of Project
<br /> � Fuel Tanks
<br />, � other. � �1,�?p l S �b � S EC 3 2D/ A-T VF c r� .
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<br /> Contractor � Company
<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/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:
<br /> Fiil out application completely.
<br /> Owner 8�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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