Laserfiche WebLink
.. 1 .q8coq <br /> 813- 780 -0020 City of Zephyrhills Fire Fax -813- 780-0021 <br /> Permit Application (ll ��' <br /> Date Received 1 Phone Contact for Permit (` )( 0 + I3 ` I Irk ) <br /> Owner's Name I \ \ (1 t ,m LW I Owner's Phone Number I I3 S3 I alOO <br /> Owner's Address U7 Donald O 5 - ?CU kAylo brats n 1 (3 <br /> Fee Simple Titleholder Name I 1 Y' 1t( 0 i \ t LLC, Titleholder Phone Number O`� 1 1 ] i L' CC <br /> Fee Simple Titleholder Address dBB[elliCa �'s'7[1TiMV '1 i 'Well&IS <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> I Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> PI Comm Exhaust Kitchen Hood /Duct n Hood Installation <br /> 0 Controlled Burn n LP /Natural Gas - Installation <br /> Ii Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> E mergency Generator > 30 kw n Places of Assembly- ANNUAL <br /> n F - ire Protection Maintenance - ANNUAL n Recreational Burn <br /> ry 'Semi' Estill Other <br /> Sprinkler El ❑ ❑ ❑ E Sparklers <br /> Fire Alarm El ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Cleaning El ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> Hood Suppression El ❑ ❑ ❑ I I n Torch Roofing/Tar Kettle <br /> El Fire Alarm Installation EKI Waste Tire Storage ANNUAL <br /> El Fire Pumps <br /> I Fire Works <br /> E Flammable Application- ANNUAL I I Valuation of Project <br /> CD Fuel Tanks <br /> Q O ther: I <br /> Contractor Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I License # ( I <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N I Fee Current 1 Y / N I <br /> Address I I License # I <br /> PLUMBER Company I <br /> Signature Registered Y / N I Fee Current I Y i N I <br /> Address I I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # ( I <br /> OTHER Company I <br /> Signature Registered Y / N I Fee Current 1 Y / N I <br /> Address I <br /> 1 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 />