Laserfiche WebLink
813-780 -0020 City ofZephyrhills Fine' Fax-813-780-0021 <br /> Permit Application <br /> j <br /> Date Received 1 ( <br /> Phone Contact for Permit <br /> Owner's Name ) Owner's Phone Number Lam_ <br /> Owner's Address <br /> _1 Titleholder Phone Number <br /> Fee Simple Titleholder Name J <br /> Fee Simple 'Titleholder Address y ,,., <br /> �'' t_.1'' ; •� ��""�'F /s�.,,a. .�''�i.' . r����':.x • �T .&'.�:i <br /> ..... . 1 Lot* <br /> Job Address <br /> Parcel # <br /> Sub Division r Wawa. : tiN. .'�x�' •.,_� «� -, _ <br /> 1 Bio-Hazard Waste Storage - ANNUAL I I Fumigation Tent <br /> 1 I Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> T - Controlled Bum 1 1 Hood installation <br /> I Emergency Generator < 30 kw 1 1 LP /Natural Gas - Installation <br /> J Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> J I Fire Protection Maintenance - ANNUAL T 1 I Places of Assembly - ANNUAL <br /> lLtrly''isemiI 1 "•"' 1 IUtner 1 <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> I <br /> Fire Alarm J J ❑ ❑ ❑ 1 1 J Sparklers <br /> Hood Cleaning �) ❑ ❑ ❑ 1 1 1 I Sprinkler System installations <br /> Hood Suppression 7 ❑ ❑ ❑ 1 I 1 I Standpipes (Sprinkler Sys) <br /> 1 1 Fire Alarm Installation 1 .I Torch Roofing/ Tar Kettle <br /> 1 1 Fire Pumps 1 1 Waste Tire Storage ANNUAL <br /> 1 Fire Works I <br /> 1 I Flammable Application- ANNUAL Valuation of Project <br /> 1 Fuel Tanks <br /> 1 I Other: 1 a <br /> Contractor Company <br /> Signature Registered Y / N 1 Fee Current I Y / N <br /> Address ( License # I <br /> ELECTRICIAN Company <br /> Signature Registered �. Y / N I Fee Current Y / N <br /> Address License # 1 <br /> PLUMBER Company <br /> Signature Registered Y / N Fee Current - Y / N <br /> Address License* <br /> MECHANICAL Company <br /> Signature Registered _ Y / N Fee Current Y / N <br /> Address License # 1 <br /> OTHER Company <br /> Signature Registered Y / N Fee Current Y / N <br /> Address I 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 />