Laserfiche WebLink
1 <br /> 837 � 80 -Cu20 City of Zephyrhills - Fire. V , G Fax -813- 780 -0021 <br /> Permit Application [ <br /> 1 _ <br /> Date Received „ <br /> Phon Contact for erml <br /> Owners Name STMPT,FXORINNELL Owner's Phone Number 813 626 5 4 8 2 <br /> Owners Address 4701 Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name - Titleholder Phone Number <br /> Fee Simple Address 1 <br /> Job Address 3'6 O ( -) Dt Nye_ . e h V h 1Iu5 Pi_ '3 35`t ` Lot # <br /> Sub Division Parcel # <br /> _. -:_ _,-,-- . .,.- ;_ ° mss.. s Y: - . <br /> 1 • Bio- Hazard Waste Storage - ANNUAL 1 1 Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct 1 I Hazardous Material (Tier If or RQ Facility) ANNUAL <br /> 1 . 1 Controlled Bum 1 1 Hood Installation <br /> 1 Emergenc < 30 kw 1 1 LP /Natural Gas - Installation <br /> . , 1 1 Emergency Generator > 30 kw 1 1 LP /Natural Gas - ANNUAL Sale <br /> 1 . 1' Fire Protection Maintenance - ANNUAL 1 1 Places of Assembly - ANNUAL <br /> 5 41 ttrly ISemil IAnI1 Other <br /> Spriner _ ❑ ❑. • 1 ( <br /> kl Recreational Burn <br /> Fire Alarm 1 1 ❑ ❑ ❑ 1' , ( 1 ( Sparklers <br /> Hood Cleaning I 0 ❑ ❑ 1 ( 1 1 Sprinkler' System Installations <br /> Hood Suppression II D .. ❑ _ • ,❑ 1 1 I 1 Standpipes (Sprinkler Sys) <br /> 1' Fire Alarm Installation 1 or Roofing/Tar cfi Rao r Kettte - <br /> (• 1 Fire Pumps Waste Tire Storage ANNUAL <br /> • I Fire Works <br /> , 1. " Flammable Application- ANNUAL I I Valuation of Project <br /> Fuel Tanks <br /> 1 Other 1 _ • <br /> r.rm au,r, a ,, - a .,..., „rte ;aA, . .. <,,!,,,...: i.. a =- . a, - <:;.a >... ,-> .. z., --= :, « v as. _ . ; * - ,-,,,,_ <br /> Contractor Company 3 re' fe, rI vti t( • Signature Registered Y / N Fee Current urrent 1' Y / N 1 <br /> Address 1 : r • 1 . _ , .. . 1 License # 1 <br /> ELECTRICIAN Company <br /> Signature - Registered Y/ N Fee Current 1 . . Y / N 1, <br /> Address 1 . I License # <br /> PLUMBER Company <br /> Signature Registered Y 1 N '1 Fee Current I Y / N:'' I : • <br /> Address 1 I License # . 1 - I <br /> MECHANICAL • Company <br /> Signature Registered Y / N 1 Fee Current 1 Y / N j <br /> . Address 1 I License # I <br /> OTHER • Company • <br /> Signature Registered Y/ N 1 Fee Current 1 Y / N . 1 <br /> _solma Address 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 /> • <br /> • <br /> • <br />