Laserfiche WebLink
,813 813-780-0020 <br /> City of Zephyrhills s-Fire to 3t7 Fax -813- 780 -0021 <br /> Permit Application <br /> ���if • - Phone Contact for Permit $ 1 3 1 46 f4, Tyrol <br /> Date Received sue max .._. ., ..•�z. r.z. ..- .. <br /> � ^ 0 A. F; ('a, Owner's Phone Number <br /> Owner's Name � ('� , . � � 1 .J� D � � 0 ����� d � / <br /> Owner's Address 1 J �r ��W <br /> 1 I Titleholder Phone Number I I , <br /> Fee Simple Titleholder Name <br /> Fee Simple Titleholder Address 1 � , �� " ' • <br /> Job Address 1 — 1 5 0 210 64 • z e_tosky `ki• t k1 FL" I Lot# 0-e7tIeso- 0490 <br /> Sub Division >R # I « ' . W ltMe D. ,.., <br /> Parcel 3--(9-6-1-607 <br /> n Bio- Hazard Waste Storage - ANNUAL 1 Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUA . <br /> n Controlled Bum n Hood Installation <br /> /9_41/ 1-11 [ /9.- <br /> E mergency Generator < 30 kw I 1 LP /Natural Gas - Installation <br /> D -- , <br /> n Emergency Generator> 30 kw LP/Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> n Ic.2trlyI !Semi1 raj Uther <br /> Sprinkler ❑ ❑ ❑ 1 I Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 I 1 Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ 1 1 1/I'prinklerSystem Installations <br /> Hood Suppression n ❑ ❑ ❑ <br /> I I I Standpipes (Sprinkler Sys) <br /> a , / / " 4,4 <br /> r -- 1 Fire Alarm Installation f Torch Roofing/Tar Kettle <br /> n Fire Pumps El Waste Tire Storage ANNUAL <br /> I 1 Fire Works 1 I <br /> p Flammable Application- ANNUAL Valuation of Project <br /> , Fuel Tanks <br /> Other: I <br /> Contractor / � / Company A_ ' Fe f 1 tSs ✓o cit Signature // V . Registered Y / N F Fee Current L t'eM Y / N I <br /> Add - 5 0 PL 5 (,l, A ) A'EQ,B 64 • Tp4 7L 1 License # 1 1 46 % a7 a o 0 e 1 =0071 <br /> ELECTRIC , N Company I <br /> Signature Registered Y / N I Fee Current 1 Y/ N I <br /> Address I 1 License # ( I <br /> PLUMBER Company I <br /> Signature , ' Registered Y / N I Fee Current I Y / N 1 <br /> Address I I License # I I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N <br /> Address I - I License # • , <br /> OTHER I. Company �� 1117.17/2 0 ; e! <br /> C V ilA I Signatur= " ~ , Registered Y'/ N Fee Current Y / N <br /> Ad ress / c 9 /j " r /as=...--.1, License # I 1 Q $ a ? c3 epo p L aov 7 1 <br /> Direction <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 />