Laserfiche WebLink
813-780-0020 City ofZephyrhills Fire t 1 553 Fax -813- 780 -0021 <br /> ' Permit Application <br /> Date Received IlMi ! i _ Phone Contact Permit 1 721 19ti 2 I Igg3 <br /> Owner's Name ISUE4M . . 4 l . / Owner's Phone Number 5/3 7f 9 7p f <br /> Owner's Address ?. »O lir, / Di 7t' y/ h- 6 ( 3 3S it, t <br /> Fee Simple Titleholder Name CI - Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address ✓ i' /7 11 2� i ' A ,I p./ 335 <br /> !/. Lot# <br /> Sub Division Parce' l # <br /> n Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> F7 Comm Exhaust Kitchen Hood /Duct I 1 Hood Installation <br /> I I Controlled Burn n LP /Natural Gas - Installation <br /> I Emergency Generator < 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> 7 Emergency Generator > 30 kw n Places of Assembly- ANNUAL <br /> I XI Fire Protection Maintenance - ANNUAL I I Recreational Burn <br /> IQtrlyl ISemil Anl Other <br /> Sprinkler El ❑ ❑ ❑ I Sparklers <br /> Fire Alarm n ❑ ❑ ❑ I 1 I Sprinkler System Installations <br /> Hood Cleaning 0 ❑ ❑ ❑ I I I I Standpipes (Sprinkler Sys) <br /> Hood Suppression I ❑ ❑ ❑ I I I] Torch Roofing/Tar Kettle <br /> I I Fire Alarm Installation n Waste Tire Storage ANNUAL <br /> n Fire Pumps <br /> 7 Fire Works <br /> I 1 Flammable Application- ANNUAL <br /> 1 i Valuation of Project <br /> I - I Fuel Tanks <br /> [ ] Other: I <br /> 1 <br /> Contractor Company A m 4,p 1 so (u .4 -von h e. I <br /> Signature c Registered Y/ N J Fee Current I Y / N 1 <br /> Address 1 35 31 1 el.54 -one, 1 1 License# E.v000O 1 <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> Address I <br /> I License # <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I YIN I <br /> Address I I I <br /> License # <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current I Y/ N I <br /> Address <br /> I License # <br /> OTHER Company <br /> Signature Registered Y / N I Fee Current 1 Y/ N I <br /> Address I I License # I <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 />