Laserfiche WebLink
9 2,1 , 3 <br /> 813 -780 -0020 City of ZephyrhillsFir•.e• Fax -313 -780 -0021 <br /> Permit Application <br /> r 0-0 ? Phone Contact for Permit <br /> Date Received • 6 ..w_ .. ...w..� <br /> I <br /> Owner's Name J Lin- M 417t 0 7 © b Owner's Phone Number _ <br /> Owner's Address _ <br /> Fee Simple Titleholder Name 1 j Titleholder Phone Number , • <br /> Fee Simple Titleholder Address <br /> Lot <br /> Job Address <br /> yq• Sub Division I I Parcel # <br /> y`Y i�Y 5 "•':, F..•.rt.,.. „:a,r'..N�' .. .. mats a;:.C!o _.w :: �.., ...., _ <br /> 1 I Bio-Hazard Waste Storage - ANNUAL ) I Fumigation Tent <br /> I Comm Exhaust Kitchen Hood/Duct U Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> ET - Controlled Burn j Hood Installation <br /> • El Emergency Generator < 30 kw I I LP /Natural Gas - installation <br /> .h54 Emergency Generator 30 kw LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL <br /> Sprinkler <br /> ❑='�semr1 ((C )vtner <br /> ❑ ❑ I/S° 1 Recreational Burn <br /> • <br /> Fire Alarm ❑ ❑ ❑ l j , I Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I 1 1 1 Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ , 1 I Standpipes (Sprinkler Sys) <br /> ; T Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> • <br /> Fire Pumps 1 I Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> in Other: l <br /> Rl.r�': W.mn, L..."a.,l y ?: "'YAN ..P. "' .. -•• J. "::f. .. :... 'f• " _.. - ... ... ..... ... y4.i... , , ...- ♦ . .. <br /> Contractor Company . <br /> Signature ‘ Registered Y / N Fee Current Y / N <br /> 6 <br /> Address • ( License # 1 <br /> ELECTRICIAN Company <br /> Sicnature Registered Y / N Fee Current Y / N <br /> Address .I License* <br /> PLUMBER Company <br /> Signature Registered _ Y / N Fee Current Y / N <br /> Address I License # <br /> MECHANICAL Company <br /> Signature . Registered Y / N 1 Fee Current , Y / N <br /> Address' License # <br /> OTHER. • Company <br /> Signature Registered Y / N 1 Fee Current 1 Y / N <br /> Address License* <br /> _ <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 (httpJ /appraiser.pascogov.com) • <br />