Laserfiche WebLink
813-780 -0020 City of ZephyrhillS Fire Fax- 813-780 -0021 <br /> 0 Permit Application <br /> Date Received /1 0 Phone Contact for Permit <br /> Owner's Name 6foi I C /OC4� KJC,t . Owner's Phone Number <br /> Owner's Address 1 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address ^ iiiie - 7h646- » \ / o h - Lot # . , ., . <br /> Sub Division 614440 Parcel # 1 <br /> _. :P.5m�.vz�,�' ua e x-. .. . 'd. wfut>,> :.= ._. 'au ...V, !A4, ,._e_ M - R"TV.n _, .,... ;.uW ... ; n <br /> I I and Waste Storage - ANNUAL n Fumigation Tent -_ -- <br /> Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Fac • ANNUAL <br /> n Controlled Bum n Hood Installation U <br /> — 1 <br /> II Emergency Generator < 30 kw I I LP /Natural Gas - Installation U <br /> I Emergency Generator > 30 kw LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL <br /> IL/My! (Semi' raj Other ��llf <br /> El I: Sprinkler n ❑ Recreational Bum J� /�U'� <br /> Fire Alarm E ID El ID [ Sparklers ���� --e_,„ . <br /> Hood Cleaning n 1:1 El ID ( Sprinkler System Installatio S � -1r <br /> Hood Suppression n I: 1=1 ID I ( Standpipes (Sprinkler Sys) ? ,/ <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle 1:_, <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> I Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> I Fuel Tanks <br /> n Other: I I <br /> Contractor Company I <br /> Signature y Registered Y / N , Fee Current Y / N <br /> Address I ( 1 I License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N j Fee Current I Y/ N I <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current I Y / N I <br /> Address I I License # I I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N, <br /> Address License # <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 />