Laserfiche WebLink
Lo# <br /> 813-780-0020; b n"`q City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> Owner's Name ecl _ [ 1 Owner's Phone Number <br /> Owner's Address niy r 1 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address �(� I 1 Lot# <br /> Sub Division Parcel# ��/ <br /> O51A ED:F�OMPAOP-ER�Y_TAX:RU- CF---- � <br /> e e- Fumigation Tent <br /> Comm Exhaust act Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Bum Hood Installation <br /> Emergency Generator<30 kw LP/Natural Gas-Installatior <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL !, / <br /> Qtrl emi Anl Ot er V <br /> Sprinkler El ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ Sparklers <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation Torch Roofingrrar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Flammable Application-ANNUAL r Valuation of Project <br /> Fuel Tanks <br /> Other: ' <br /> Contractor Company <br /> Signature Registered I Y01)1 Fee Current I Y/N <br /> Address ' License# 1 4 10(4dS <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Curre Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered /N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registere Y/N Fee Current Y/N <br /> Address F License# <br /> Directions: <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) <br /> VA <br /> 33 y <br />