Laserfiche WebLink
81F 780 -0020 City of Zephyrhills Fire — il — (l 550 L Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received I YOCt Phone Contact for Permit ,I I I 1 <br /> .. ,, ..;a. <br /> Owners Name ZV p•/ T o e x�c.r 5 Owner's Phone Number €1 )g 3 ) It 15 <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address 1 I <br /> a,.>o;, ; n M:: . "i ?.:,. i ';.,.WVAtq'AVR' r4EV ; WR :Vr4M aPMV:�C SM °. R.,. A.ZM�„..MM r ;€ N�.. MW,I ;" . ,: ¢ 'BSc i�. KitiV `^;���s .:¢.: �E TG M'T' <br /> Job Address ) 1d 9 &A_ ? Iu p Lot # <br /> Sub Division Parcel # <br /> .. ;cv,_ r.J :we. rrr. 4 -, ,,� k , . +E 3,..s Y. r., Sr'S'�, m':p. to .wh ..�; a'8 t �.M „ ��.. :.u <br /> �„r",.�ze��.y � �< a" �°�..ta�.� & »..,��'�.:au;r�ik�tt ,.. �.a��:�t�.�,«� .n��..� a„ ,4�...r�r,:��.r . <br /> Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> FT Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Ti Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> IUtriyI isemil (Anl� Other <br /> Sprinkler n ❑ 0 ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 I Sparklers <br /> Hood Cleaning ILI ❑ ❑ ❑ I 1 n Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ W 1 1 n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation I I Torch Roofing/Tar Kettle <br /> I Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> ri Flammable Application- ANNUAL ( I Valuation of Project <br /> El Fuel Tanks <br /> F Other: I I <br /> .mm `" .... gfea.,...:x N. ameg? a:@ sF:€"', :; ..,.k.��i : <.h a.3.�a . r.,: ,.iaagg e's` ",: waggef.�.:.�.zaz a .�a.,..£. .i_:s.,, ze �...... ,Mkz+a,s.K._. 0 Eiga{M:ag. A. : .:?'!:. .. »� ..?: B ' <br /> Contractor ��� Company 5PP.c �it E C F;a,e I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N <br /> Address Nees 11 A as r„w)t i tafte r(. I License* ( I <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N j Fee Current I Y / N J <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y/ N ,I Fee Current I Y / N I <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address License # I <br /> <.... t.. sa.. n,.> a 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 />