Laserfiche WebLink
813 -780 -0020 City of Zephyrhills Fire Fax -813 -780 -0021 <br /> 7 6,411,c' / Permit Application <br /> Date Received Phone Contact for Permit <br /> - .::.r., -.. ',uurea ., v .�.;.. * ,*.._->c s.4r , t€r _ .: � ,...?�e: s - .'; s v ti.' — I .. <br /> Owner's Name LON ` l eV �'(` 6v►he t Owner's Phone Number 3 (Q <br /> Owner's Address 1 4 7 ( QccV• tr ti VA 1 IM t- ?hir <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address 7 C @1 r \_-U IL_Ntt. 7P ' \- 11 . in kL 33S4-(t Lot# <br /> Sub Division I Parcel # <br /> L�'�.�s.a;�� ':�- �����z�: «�_�- ::.�;;:..._.ra �a:' _ ':; �. �*. �;,. �.=-> '••<.xs.K�ay.•tas�a?a��uv�.�,r .�- .�°.s'e:i. �:-.: . • -. :� °.�: '- �"sG <br /> I Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> n Controlled Bum I I Hood Installation <br /> I I Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> Lim J n �� <br /> Sprinkler ❑ ❑ V e� 4' Recreational Bum 0 <br /> Fire Alarm 0 ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I I I Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ I I I I Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> F Fire Pumps I I Waste Tire Storage ANNUAL <br /> I I Fire Works <br /> I I Flammable Application- ANNUAL I 1 Valuation of Project <br /> F Fuel Tanks <br /> n Other: <br /> EftEgginnir <br /> 9' ,_ fa , ^ YWk. , 3 .. ... ,.: : ,- 7 'Hw " YC3-??v, .,w.aia�+.aa.. f.. '2.am.'#&U*.z:l�:.P�€^st;.&.!, M1 Cdsa",k' <br /> Contractor Company .3 CYr•''- ( ( I <br /> Signature Registered Y / N Fee Cu Y / N <br /> Address ( I License # <br /> ELECTRICIAN - Company <br /> Signature Registered Y/ N J Fee Current I Y/ N I <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y/ N J Fee Current I Y/ N j <br /> Address I <br /> 1 License # , I <br /> MECHANICAL Company <br /> Signature Registered Y / N . 1 Fee Current I Y / N <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N 1 <br /> Address 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 /> • <br />