Laserfiche WebLink
813 -780 -0020 City of Zephyrhilis Fax -813 -780 -0021 <br /> Permit Application sC es <br /> Date Received Phone Contact for Permit Willi M WWII" <br /> Owners Name Owners Phone Number I 1 <br /> Owners Address - 7833 Go L.L. Lv b. <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I I <br /> 1 <br /> Job Address T 3 GI ' B.L,v o , Lot # <br /> Sub Division Parcel # <br /> El Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> El Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> E Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> plan mug Lau °trier <br /> Sprinkler IM r ❑ ❑ n Recreational Bum <br /> Fire Alarm El ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation = Torch Roofing/Tar Kettle <br /> Fire Pumps Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL 1 I Valuation of Project <br /> Fuel Tanks . ED <br /> 0 Other: <br /> .�, ..., ._..r< <br /> Contractor 11111111W <br /> a it ny G,. _ ` . Ss <br /> Signature Registered ©M Fee Current Y / N <br /> Address r/� r l kAtio mympr License # C: •'�};2'r1 /3W r'�,i'alEll <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N Fee Current I Y/ N <br /> Address I I <br /> License # <br /> PLUMBER Company <br /> Signature ,, Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N - I <br /> Address I r I License # I <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current Y / N <br /> Address <br /> 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 />