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813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> Permit Application
<br /> Date Received Phone Contact for Permit
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<br /> Owners Name Owner's Phone Number � � �
<br /> IOwner's Address
<br /> Fee Simple�Titleholder Name Titleholder Phone Number � � �
<br /> Fee Simple Titleholder Address �
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<br /> Job Address' ��� c✓� , � '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 /> �y emi n t er
<br /> Sprinkler � ❑ ❑ ❑ � Recreational Burn
<br /> � Fire Alartn � ❑ ❑ ❑ � � Sparklers
<br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
<br /> �es,i\ ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> Fire Alarm I � Torch Roofing/Tar Kettle
<br /> Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br />' � FlammableApplication-ANNUAL Valuation of Project
<br /> � Fuel Tanks
<br /> Q Other:
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<br /> Contractor �� � Company s
<br /> Signature ,;y%. Registered Y/N Fee Current Y/N
<br /> Address / -�/� .t. Ci Z/J— ' i� � License# F' �QO /Oy
<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 /> Fill out application completely. ' -
<br /> Owner&Contractor sign back of application,.notarized( r,copy of signed contract with ovirner)
<br /> If over$2500,a Notice of Commencement is r@quired( echanical work over$5000) , ' ,
<br /> Supply two(2)sets of drawings with applicable documen ation " ' � - - _
<br /> Allow 10-14 days for review after submittal date. �� Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
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