Laserfiche WebLink
<br /> <br />813-780-0020 <br /> <br />Date Received. <br /> <br />Owner's Name - <br /> <br />Owner's Address <br /> <br />City of ZephyrhillsFire <br />Permit Application <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br />11018 I JG,s;-7f-) I <br /> <br />--<1 <br /> <br />Titleholder Phone Number <br /> <br />II <br /> <br />II <br /> <br />..t!lllIIlm1it~_'1J~lmi1,'lJm! <br /> <br />Parcel # <br /> <br />fe, <br />I <br /> <br />(Ul:S I AIN~U f-KUM I-'KUI-'~K I Y I AX. NU J Il,;~) <br /> <br />5~~1.[2 <br /> <br />Lot # <br /> <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />-~_!iII <br /> <br />Contractor <br />Signature <br /> <br />Address <br /> <br />ELECTRICIANI <br />Signature . <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature . <br /> <br />Address I <br /> <br />Bic-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />Sprinkler 0 <br />Fire Alarm 0 <br />Hood Clean/Suppression 0 <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />--- <br /> <br />OTHER <br />Signature <br /> <br />Address <br /> <br />D Fumigation Tent <br />D Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />~Iaces of Assembly-ANNUAL <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />llb~_ '-~"'_F <br /> <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N Fee Current <br /> <br />Y/N <br /> <br />. Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Directions: <br /> <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. <br />