Laserfiche WebLink
813 - 780-0020 - Q City of Zephyrhills Fire Fax- 813- 780 -0021 <br /> i l) d G Permit Application <br /> Date Received earjrafill Phone Contact for Permit I 1 1 1 1 <br /> Owner's Name I 1 lorii & SCA mixs 1 1 P1°,r tlt.0 �n�` <br /> y�//�� \ 1 Owner's Phone Number 1 S 1 3 I ('I $ 2 I �(.i <br /> © <br /> Owner's Address 1 O o<'1 FO - kV00CI Dr G- c C-0 , . b 9 04 a <br /> Fee Simple Titleholder Name I Titleholder Phone Number I I <br /> Fee Simple Titleholder Address (1 I <br /> Job Address ( Co /01 Df2it '2d 2 a c k 6 I Ls ` FL_ 3 iL/ Z Lot # I <br /> Sub Division Parcel# Ia ab -'.I -Oolo- 03gw -oo1a <br /> n B io -Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n C omm Exhaust Kitchen Hood /Duct n Hood Installation <br /> E i Controlled Bum LP /Natural Gas - Installation <br /> F-7 Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> ED Emergency Generator> 30 kw <br /> Places of Assembly- ANNUAL <br /> Fire Protection Maintenance - ANNUAL Recreational Burn / <br /> 5 ^ r. <br /> C T ry / print ® Other i ' /7/ j <br /> 1"LQ 4d Sprinkler qr ❑ ❑ 0 Sparklers 4..._q/ <br /> 1/ zLi I e q Fire Alarm E] ❑ ❑ ❑ <br /> ❑ I I n Sprinkler System y tom Installations <br /> Hood Cleaning ❑ ❑ ❑ n Standpipes (Sprinkler Sys) <br /> Hood Suppression [I] ❑ ❑ ❑ I I n Torch Roofing/Tar Kettle <br /> n Fire Alarm Installation n Waste Tire Storage ANNUAL <br /> a Fire Pumps <br /> n F - ire Works <br /> n Flammable Application- ANNUAL <br /> ri Valuation of Project <br /> F uel Tanks <br /> 1 1 Other: I <br /> Contractor <br /> Signature CA,:iec. 0 if Company r il,r0fcti -1 ,,J <br /> Registered MM. Fee Current mILIII <br /> Address 4 • P . ,' S , s •I . a : 3 - 3 , License # I1k b9 g 2- DD 1 19 Ss 1 <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I 1 <br /> PLUMBER Company I I <br /> Signature Registered Y/ N J Fee Current 1 Y / N,I <br /> Address I I License # I <br /> MECHANICAL Company I <br /> Signature Registered ( Y / N , Fee Current I Y / N I <br /> Address I <br /> I License # <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address ( I 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 />