Laserfiche WebLink
!'i City of ZephyrhillsFirt• Fax -813- 780 -0021 <br /> 813- 780 -002 Application Permit on <br /> . , - - ,/ Phone Contact for Permit� <br /> Date Received r �i. <br /> J ..., N 1' . ' d Q f'1 J Owner's Phone Number 1 ( 3 1 4.2.0 I6�'>i -- <br /> Owners Name '�f <br /> Owner's Address J I I J <br /> Titleholder Phone Number <br /> Fee Simple Titleholder Name <br /> Fee Simple Titleholder Address ) ,E C j 1 <br /> k JEiL""�' :..:.. �4 '•vr >.aia v.. :. ,:. ,.. ^:vn.• ' ".a. ':..':. -: r.F•s_ „k , x_ ._ . «, � , � ... .. .�h � .l \ � J # l <br /> •Sob Address <br /> I (06to � a1..-- (L3 ZAP 1/4 r- '. \ '-t_ 3 Lot <br /> Sub Division J Parcel # �5 y - :: «f .• °. <br /> n Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> rY Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n - Controlled Burn n Hood Installation <br /> n Emergency Generator < 30 kw 1 I LP /Natural Gas-Installation <br /> I I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale ' <br /> Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL <br /> )c1mY'Jsemi1 =1,1 ❑ ❑ ❑ 1Ctiher 6,1-0 Sprinkler Recreational Bum Fire Alarm El ❑ ❑ ❑ .- <br /> 4 <br /> ( ET Sparklers ' / 1 9 <br /> / <br /> Hood Cleaning ❑ Cd' ❑ I I 1 1 Sprinkler System Installations / i I 9 <br /> Hood Suppression ❑ ❑ ❑ I I I I Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation I' 1 Torch Rooting/Tar Kettle <br /> El Fire Pumps I ( Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application- ANNUAL 1 Valuation of Project <br /> 7 Fuel Tanks <br /> .,.,.... Y._ ,:. ,,:.,FS..M .v#.._ ..err .......t .F •nb3'._4.. a. <br /> Other: I <br /> Contractor _ aN `�J , n 0.-k._ Company . <br /> S- <br /> Signature s r i Registered Y / N I Fee Current I Y / N I <br /> Address. 3g3 .--r ? r )-1 License* 1 1 <br /> ELECTRICIAN Company <br /> Signature Registered Y / N Fee Current 1 Y/ N I <br /> Address I License* I 1 <br /> PLUMBER Company <br /> Signature Registered Y / N 1 Fee Current I Y/ N 1 <br /> Address I License # <br /> MECHANICAL Company <br /> Signature Registered _ Y / N I Fee Current Y / N <br /> Address 1 License* <br /> OTHER Company <br /> Signature Registered Y / N ( Fee Current I 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 />