Laserfiche WebLink
r <br /> b 13 -7EQ -0020 City of Zephyrhills'Fire °' / l b Fax- 813 -780 -0021 <br /> Permit Application <br /> Q. P Y.: / Phone Contact for Permit 13 5 1q--c f <br /> Date Recerved_ , ` D 7�.. .�. <br /> Owner's Name Z-452/ 2-/ I 4 I7/2 4 774 1 Owner's Phone Number 2 ( 3 SS 13 S j <br /> Owner's Address PO 210k 6 173 //9( 'fA 7LL 3 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> / � � /� ` /— . / p (;A-L, ' / x , Ps , rr: • :.+a a '. ,fig, a:i5„';°A <br /> Job Address ' /vG G`qI�E -(t/ J //O 21z-v0 Lot# <br /> • <br /> Sub Division Parcel # <br /> _ ,x �. , a<�..��a..m ,.:.,��}..�._ €=:::r r- . ..,._,. R .. _ .,. - ... , .. .. ,a . _ ::;�,� Y txai'a✓rh . ,. =t -a.ca ,s,�, . k s- r+,.u,�,.� ,.;rn 3ero. x , <<,:- ..,. <br /> Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum n Hood Installation <br /> I Emergency Generator < 30 kw • 1 1 LP /Natural Gas - Installation <br /> Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL <br /> try !bermI f l Uther <br /> Sprinkler 1 1 ❑ ❑ ❑ I Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I I Sparklers <br /> Hood Cleaning / ❑ ❑ ❑ 1 WOWS 1 Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ ( ( ( I Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> I I Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL 1 I Valuation of Project <br /> n Fuel Tanks <br /> fl Other <br /> p �—�— �� �/� � t-�— <br /> Contractor Company C/Iv v1�SE SC�/w /c..- -> <br /> Signature s °4± Registered Y / N I Fee Current I Y / N <br /> Address I License # 1 <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # ( I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address l I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current I Y / N I <br /> Address I I License # I I <br /> OTHER Company <br /> Signature Registered Y / N I Fee Current I Y / N I <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 If - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />