10-10206 - Laserfiche WebLink

Browse Search

813- 780 -0020 City of Zephyrhills Fire Fax -813- 780 -0021 Permit Application Date Received r (_. Phone Contact for Permit 721 I, 144 2 I t q q 3 Owners Name .j I ii "A, r f : /4 Owners Phone Number l t/3 1 7 -7/,7 I Owner's Address 're,k Q Awr Pr. Zer y (A'/i' s PI s3sy�. Fee Simple Titleholder Name f / Titleholder Phone Number Fee Simple Titleholder Address I Job Address 7 7g»0 ir/(/, pc. Zf A f I /' /S , /• 3 .Fs a Lot # Sub Division j I Parcel # I D Bio- Hazard Waste Storage - ANNUAL a Hazardous Material (Tier 11 or RQ Facility) ANNUAL r i Comm Exhaust Kitchen Hood /Duct n Hood Installation I I Controlled Burn = LP /Natural Gas - Installation n Emergency Generator < 30 kw I 1 LP /Natural Gas - ANNUAL Sale n Emergency Generator> 30 kw n Places of Assembly-ANNUAL I XI Fire Protection Maintenance - ANNUAL a Recreational Burn a IQtrlyI !Semi, (J Other Sprinkler ❑ ❑ ❑ 0 Sparklers Fire Alarm ® ❑ ❑ Ix I I n Sprinkler System Installations Hood Cleaning ED ❑ ❑ ❑ I 0 Standpipes (Sprinkler Sys) Hood Suppression ❑ ❑ ❑ I I n Torch Roofing/Tar Kettle n Fire Alarm Installation a Waste Tire Storage ANNUAL 1J Fire Pumps El Fire Works a Flammable Application- ANNUAL ' ( Valuation of Project Fuel Tanks n Other: - -=.t max_ _ Contractor Company A -'- 4v so ( j,•pn knew. I Signature c.,, Registered Y/ N Fee Current I Y/ N I Address I 3531 1'iQ 4 -one Rd. I License # I EF0000 A IM ; I ELECTRICIAN Company Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # I I PLUMBER Company Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # i MECHANICAL Company Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # OTHER Company Signature Registered Y / N . 1 Fee Current I Y / N I Address I License # I Directions: Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)