Laserfiche WebLink
813-780-0020 f \ s,t City of Zephyrhills Fire. Fax - 813780 -0021 <br /> . /"/)( Permit Application <br /> Date Received 3 /C7 P mit <br /> 1 <br /> Phone Contact for P r <br /> Owner's Name , S TMPT,FX(RINNELL Owners Phone Number 813 626 15 4 8 2 <br /> Owners Address 4701. Oak Fair Blvd TAMPA FL 33610 <br /> Fee Simple Titleholder Name - - Titleholder Phone Number l <br /> Fee Simple Titleholder Address 1 <br /> Job Address 3 •I51 Lauv -1 vail -e gills_ • Z-e lrh ;L. 33 5421 Lot # <br /> Sub Division Parcel # <br /> E --. -,- °. '. , • . ... : .--, ,r,--- - •..., 5,. . :R...... .� - - ..:. -^.,--,A - r.:. - :: >z ur ..., ,,:• - . - .- we.-'- , >ss : . : a;.Eatwm,.� <br /> 1 • I Bio- Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> I Comm Exhaust Kitchen Hood /Duct Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I . Controlled Bum I Hood Installation <br /> I Emergency,Generator < 30 kw I LP /Natural Gas - Installation <br /> - • I I Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale /12 <br /> , R 1 1' <br /> 1 Fire Protection Maintenance- ANNUAL I Places of Assembly- ANNUAL( di l / <br /> •v 'Semi' IAN I Other i / <br /> Sprinkler. c ❑ 0 ( Recreational Bum ■_ <br /> Fire Alarm I I ❑ ❑ ❑• I , L Sparklers . . <br /> Hood Cleaning I I 0 ❑ ❑ I I I I Sprinkler System Installations <br /> r . . Hood Suppression I I ❑ ❑ ❑ I I I I Standpipes (Sprinkler Sys) <br /> Fir Alarm Installation Torch orcn Roofingrrar Kettle <br /> Fire Pumps I • I . Waste Tire Storage ANNUAL <br /> I Fire Works . <br /> 1 ■ F lammable Application- ANNUAL a <br /> I I Valuation of Project <br /> I Fuel Tanks <br /> I' 1 Other: 1 <br /> • <br /> �^atYFd+ -e.ar' <br /> Contractor f <br /> Company - et F...i.. -' t <br /> Signature / . Registered Y/ N I Fee Current 1• Y/ N j • <br /> Address I ;:.. <br /> .. ... 1' , V License # 1 ' <br /> ELECTRICIAN <br /> ,. Company . • <br /> Signature • : ' Registered Y / N I Fee- Current 1 Y/ N .. 1 <br /> Address I _ - 1 License # 1 l <br /> PLUMBER I Company ,5` <br /> Signature Registered ¥ / N' I Fee Current 1 Y/ N I <br /> Address I <br /> 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 <br /> Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N . 1 <br /> Address License # <br /> .>•.• <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 /> • <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 />