Laserfiche WebLink
813-780-0020 City of Zephyrhills Fire• 4k 4 <br /> £ ' Fax- 813 -780 -0021 _ <br /> Permit Application l " _ __- <br /> Date Received Phone Contact for Permit <br /> Owners Name I C ■U I Own er's Phone Number 14101 I "Igo I 1 \o t" , <br /> Owners Address I 2 4 @ a. \, (;\062 7-40AQ ,`kti , I <br /> Fee Simple Titleholder Name 1 1 litleFwider Phone Number 1 11 I I <br /> Fee Simple Titleholder Address I I <br /> Job Address ( I Lot # 1 I <br /> Sub Division I I Parcel # 1 I <br /> E1 Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Imo, Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Contmiled Bum n Hood installation <br /> a Emergency Generator < 30 kw n LP/Natural Gas- Installation <br /> n Emergency Generator > 30 kw n LP/Natural Gas - ANNUAL Sale <br /> El Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> ®®® <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fe e Alarm n ❑ ❑ ❑ I 1 n Spatters <br /> Hood Cleaning N ❑ X ❑ 1 1 E3 Sprinker System Installations <br /> Hood Suppression ❑ ❑ ❑ 1 1 n Standpipes (Spring Sys) <br /> Fire Alarm Installation n Torch Roofingfrar Kettle <br /> Fire Pumps n Waste The Storage ANNUAL <br /> Fire Works <br /> Ftatrvrrabie - ANNUAL ( I Valuation of Project <br /> Fuel Tanks <br /> Q er: <br /> Contractor +� ry I <br /> N. Signature r. A. it �� 1� ' .. A Registered Y / N ' Fee Current ( Y / N 1 <br /> Address it e� - la a _ - ' se # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y 1 N I Fee Current I Y/ N <br /> Address I I Ucense # I I <br /> PLUMBER I Company I <br /> Signature Registered ¥ / N Fee Current I Y/ N I <br /> Address I I License # I <br /> MECHANICA9 Company I <br /> Signature Registered ` Y/ N I Fee Current I Y/ N J <br /> Address I 1 License # I I <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current 1 Y/ N j I <br /> Address License # <br /> Directions= <br /> FM out appIcafion completely. <br /> Owner & Contractor sign bade 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 />