Laserfiche WebLink
813 - 780 -0020 City of Zephyrhills Fire .// \ 1)D g1) Fax - 813 -780 -0021 <br /> Permit Application y r <br /> Date Received <br /> Phone Contact for Permit P r <br /> Owners Name �CuS S � Owners Phone Number • l <br /> 19(4-419(4-4.- ' f� ►Y <br /> Owner's Address ms 'Srd Poe. G.. tikp(ht 11 r% Js641 <br /> 1 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> .. r - <br /> Job Address . � fh Avc G llt rh) I Is FL !35'7 L Lot# <br /> Sub Division <br /> Parcel # 11 2.1' W 15300 - oIZD <br /> n Bio-Hazard Waste Storage - ANNUAL I I Fumigation Tent <br /> n Comm Exhaust Kitchen Hood/Duct { ] Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum Hood Installation <br /> I I Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL El Places of Assembly- ANNUAL <br /> (Lttriy( (Semi( rrnTI Other <br /> Sprinkler is ❑ ❑ • Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I Sprinkler System Installations <br /> Hood Suppression 71 ❑ ❑ ❑ I I Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation Torch Roofing/Tar Kettle <br /> 17 Fire Pumps In Waste Tire Storage ANNUAL <br /> I Fire Works <br /> I Flammable Application- ANNUAL I Valuation of Project <br /> I Fuel Tanks <br /> fl Oth ; I <br /> Contractor Company C • , In j Gat R r y� , Inc I <br /> Signature dika hA / Registered e' N Fee Current / N <br /> Address I 1 License # I f F 0000 ) gS' <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N j Fee Current I Y/ N I <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I I License # <br /> MECHANICAL Company I <br /> Signature . Registered Y / N Fee Current I Y / N j <br /> Address I License # I <br /> OTHER Company I <br /> Signature Registered Y / N _ Fee Current 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 # - obtained from Property Tax Notice (httpJ /appraiser.pascogov.com) <br />