Laserfiche WebLink
. 81?-780-0020 City of Zephyrhills Fire q1;71 Fax - 813 -780 -0021 • <br /> Permit Application <br /> Date Received L Phone Contact for Permit 8.3 <br /> Sce <br /> Owner's Name A. r_..il/liJlF / - ( O / at' Owner's Phone Number 3.Sz 1 $gg I ,7-gce <br /> Owner's Address __. 6 'i <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> ...„'k :a 'M.., Y: -tt : ;: x. f mss! tr : et t_ AItERFOCti "RomINI,,,a`€ .engo =,' '. , . ,M.. ,VCI k ILWW . _ . Z t.e4. 1De ;M,...MIA:Z I A. M, <br /> Job Address . j ' /l/ ‘77 eAe/ <br /> Lot # <br /> Sub Division Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> ni Controlled Bum n Hood Installation <br /> I - I Emergency Generator < 30 kw I I LP /Natural Gas - Installation <br /> I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> pi Fire Protection Maintenance - ANNUAL Places of Assembly - ANNUAL <br /> IT r y � Semi l [ Uther <br /> Sprinkler 1 ❑ ❑ ❑ 1 I Recreational Bum <br /> Fire Alarm 7 ❑ ❑ ❑ 1 I I Sparklers <br /> Hood Cleaning 7 ❑ ❑ ❑ I I Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ 1 1 1—I Standpipes (Sprinkler Sys) <br /> ri Fire Alarm Installation I-I Torch Roofing/Tar Kettle <br /> I—I Fire Pumps I] Waste Tire Storage ANNUAL <br /> I] Fire Works <br /> � <br /> ;�� Flammable Application- ANNUAL I I Valuation of Project <br /> l___,I Fuel Tanks <br /> n Other: I <br /> Contractor .�, �....., tee.. � r , :w, ��E.�?�s <br /> Company <br /> c <br /> Signature <br /> r' Registered Y / N ,I Fee Current I Y / N <br /> Address License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N . 1 Fee Current I Y / N - I <br /> Address I <br /> I License # <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N } <br /> Address I <br /> I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N J <br /> Address I I License # <br /> OTHER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I 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 />