Laserfiche WebLink
<br />813-780-0020 City of Zephyrhills Fir€ U. ~111 V Fax-813-780-0021 <br />. ' Permit Application ~ <br /> <br />"~~~1'::;~:~I_'_W$LiL~UJJL_'_i#%"%,l-la~___~:;~m"-1l,,~,,Z,,l!~~~J <br />l~~~F g:tJ:,c:;?;~.~~~;~:m;~13~~6t II ! <br /> <br /> <br />Fee Simple Titleholder Name I I Titleholder Phone Number I II II I <br /> <br />I I <br />1. :itJ 28 .4<1L ~..r /2cI 1'01# I <br />. I Parcel # I / 2-~ - Zl-()O()()- <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Contractor <br />Signature <br /> <br />Address I. ~ 7q /~ <br /> <br />ELECTRICIANI <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature <br />Address I <br />OTHER <br />Signature <br />Address <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~~~~ <br />Sprinkler D 0 0 0 L-J <br />Doooc=J <br />Do ooc=J <br />Do ooc=J <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br />~ Fire Alarm Installation <br />~ Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br />D Other: I <br /> <br />I L LJJJ <br /> <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofinglTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />~...1- ...1. IJ~ oV <br />, <br /> <br />Valuation of Project <br /> <br />)fr:-&i;LJ., r/L <br /> <br />J7/Ci.7-+ <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />.5 j)~ Ci 4/1- r &/r-d-"f'" Ie 5$t.ik~ U <br />Y I N I Fee Current L Y I N I <br />IE jC 000 /CJo/~ I <br /> <br />Y I N Fee Current Y I N I <br />I <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <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. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />