Laserfiche WebLink
813 -780 -0020 City of Zephyrhills Fire Fax -813 -780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> 1. -DGEW ov Owner's Phone Number <br /> Owner's Name � 2 � AA 1� � r f? <br /> Owner's Address 3:7y dP ,(./ ©o7) .f/ <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> zc x.:. .d6ca .. , ..aH . ,f'dl a', <br /> R. rn .. ... .>20. Y..- ,. ..., e, +.. .. .,.w.. .Q ,,.q qe.. .. :n. ,... .a,, n.,.w ,.ba....... ....n.... <br /> Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> F - 7 Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL <br /> IUtrlyl !Semi' Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I I I Sparklers <br /> Hood Cleaning IT ❑ ❑ ❑ I n Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I I Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> I Fire Works <br /> ^ 1 Flammable Application- ANNUAL I I Valuation of Project <br /> I Fuel Tanks <br /> F 1 Other: I <br /> .'D. ..NE. ...�. a ,..3 _. af. VIiktM S'..,F• � wre`,sasx a �.H, ..:�t O'tZiz; ara"' M6V _...ten '..S..: :aa ,.a.. a.. az :I Ad tri:: .... :a..x EM46.. ....a;: r.?z.....K:.,w:: <br /> Contractor �� J /� / Company <br /> Signature �� /, ice/ .1C/ ' ` t Registered Y / N ] Fee Current 1 Y / N _ <br /> Address I v I License # <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N _I Fee Current I Y/ N I <br /> Address I I License # <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I <br /> I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N J Fee Current I Y / N I <br /> Address I I License # <br /> OTHER <br /> 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 />