Laserfiche WebLink
813- 780-0020 City of ZephyrhillsFire- <br /> 9 Fax - 813 - 780-0021 <br /> Permit Application - <br /> late Received Phone Contact for Permit 11 1 T1 l <br /> )wner's Name ` a Owners Phone Number X / j } ?� i, 5 <br /> )wner's Address lD v () L %Ili D r {,tsc0 a .)t) (l_✓► a C <br /> =ee Simple Titleholder Name Titleholder Phone Number 1 I <br /> =ee Simple Titleholder Address ( 1 <br /> Job Address J ,, nn 11 - .(_ Lot # - <br /> 1 f` Lc� K S 0 �c �. P <br /> 3 -a.� 7o -0t jC0 <br /> Sub Division 1 arcel I v <br /> `. n Bio-Hazard Waste Storage - ANNUAL o Fumigation Tent } <br /> ED Comm Exhaust Kitchen Hood/Duct I 1 Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> 1 1 Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> g, <br /> Emergency Generator> 30 kw f ( LP /Natural Gas ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> Laa 'Semi+ r""' 1 Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm 1❑ ❑ ❑ 1 n Sparklers <br /> Hood Cleaning ❑ ❑ ❑ 1 1 u Sprinkler System Installations <br /> Hood Suppression 0 ❑ ❑ ❑ 1 1 1 1 Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation 1 I Torch Roofing/Tar Kettle <br /> R Fire Pumps I ` Waste Tire Storage ANNUAL <br /> Fire Works • <br /> Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> n Other 1 <br /> Contractor �., ` . Company C/ �c- ty F e/CCeuN 5'YF ti� <br /> Signature r Registered Y / N 1 Fee Current 1 Y/ N 1 <br /> Address 1 3 7c1 / q `-J ' i it 4 / t,--4— 1 License it 1 <br /> ELECTRICIAN Company <br /> Signature Registered Y / N Fee Current Y / N <br /> Address 1 1 License* 1 1 <br /> PLUMBER Company <br /> Signature Registered Y / N 1 Fee Current I Y/ N 1 <br /> Address 1 1 License # 1 1 <br /> MECHANICAL Company <br /> Signature Registered Y/ N 1 Fee Current [ Y/ N 1 <br /> Address 1 1 License* } ( <br /> OTHER Company <br /> Signature Registered Y/ N ' Fee Current 1 Y/ N j <br /> Address 1 License # <br /> , x ; , yew 1 ;e�". "s -''_ �.. <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 S2500, 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 it - obtained from Property Tax Notice (http:tlappraiser.pascogov.com) <br />