Laserfiche WebLink
813 - 780 -0020 City of Zephyrhills Fire Fax - 813- 780 -0021 <br /> Permit Application <br /> Date Received 1 rO I ZS I Q9 1 Phone Contact for Permit 1 81 3 1 102 41 1 11„ 1 <br /> Owner's Name 1 ]411 i itt nee— a hureh er zep hyrh4 I IS 1 Owner's Phone Number 1 S13 I I 4-09 I 1 ? 003 <br /> Owner's Address 1 L Q51 FOC* ki tA9 Pei , r .", 415 FL 3 3S� Z I <br /> Fee Simple Titleholder Name I . Titleholder Phone Number <br /> Fee Simple Titleholder Address 1 �) <br /> Job Address I FOC 4'01 l !rktIISi FL. 33 SC/ 2 Lot # I I <br /> Sub Division 1 N 1 A Parcel # 1 3 - 2 fa Z1 -o o f o- 095oo -vox' <br /> E Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Comm Exhaust Kitchen Hood /Duct = Hood Installation <br /> El Controlled Bum n LP /Natural Gas - Installation <br /> E Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale,/ / n <br /> El Emergency Generator > 30 kw n Places of Assembly -ANNUA <br /> ® Fire Protection Maintenance - ANNUAL = Recreational Burn <br /> raTFI71 EMM Other �( • <br /> Sprinkler ® ❑ ❑ 0 Sparklers !' I1 f <br /> 6 ��� <br /> ❑ <br /> Fire Alarm E ❑ I=1 I I n Sprinkler System Installations �� f <br /> Hood Cleaning n El 11 El ( I n Standpipes (Sprinkler Sys) !1 i <br /> Hood Suppression CI ❑ I I n Torch Roofing/Tar Kettle 1 40, - <br /> E Fire Alarm Installation n Waste Tire Storage ANNUAL , <br /> E Fire Pumps <br /> E Fire Works <br /> E Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> EJ Fuel Tanks <br /> 0 Other: I <br /> Contractor �) ` , Company • i Fl I • ` . a '1r! <br /> Signature .i 0 Registered ��� Fee Current rii <br /> Address Ili t C Y ro • - t '1/4-\ 3t93 I 1 cvt�ou FL 7 1 License # 101 to 4 12 2 000 1 l g 8 5 I <br /> ELECTRICIAN Company I <br /> Signature Registered 1 Y / N I Fee Current I Y / N <br /> Address 1 I License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address I I License # I <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current 1 Y / N I <br /> Address 1 I License # 1 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 />