Laserfiche WebLink
. 813-780-0020 City of.Zephyrhills -Fire (a z3 Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received f / ° Phone Contact for Permit <br /> Owner's Name ( _., <br /> �� r I I , - S - Owner's Phone Number I ?/ 3 1 I � I fY o <br /> Owner's Address �� j� / ` J ` l s / 3 ?S _ y L <br /> Fee Simple Titleholder Name Titleholder Phone Number 7 <br /> Fee Simple Titleholder Address <br /> :: - s .„ <br /> ��;u;:xv.:." �i;^ei.^erzv,,.;zT�dt'=•, , "�:r w '..".:.� ya � ' . 3 �;,,...:s ._.._. ..�a.:e� �r�:x �� ..s�»`maa tr �:�,,. w�:.n '.€.`�,rc.'�4°.::J.i, i..�� '3d,,.. irn „-r,*: <br /> Job Address <br /> Lot # <br /> Sub Division Parcel # I <br /> Bro -.7 °, au.M,.� � > �xra.w +-, n- re. - -�., .ra?,r ... a ,.a•_ =.,- ., k <.,�n: « , �� „ .?'nTMK°�C. -:. s:�vas ... .... �• k+�rasSa.rm. <br /> Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier 0 or RQ Facility) ANNUAL <br /> Controlled Bum n Hood Installation <br /> Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> I I Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale S <br /> Fire Protection Maintenance - ANNUAL K Places of Assembly- ANNUAL <br /> I(ltrlyl'ISemrl prrl Other <br /> Sprinkler n ❑ ❑ ❑ I Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I n Sparklers <br /> Hood Cleaning r ❑ ❑ ❑ I 1 I 1 Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ I I I I Standpipes (Sprinkler Sys) <br /> I I Fire Alarm Installation I I Torch Roofing/Tar Kettle <br /> Fire Pumps I Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I Valuation of Project <br /> Fuel Tanks <br /> Other: I <br /> !Sxa'w. x' .,.:t ,,.,,�..;: :az - <., ww...,.,.�+e se«..:::_d. ¢•:<..,, ..� , . r < a > c c �-�' <br /> Contractor <br /> Company <br /> Signature Registered Y / N I Fee Current Y / N J <br /> Address I <br /> License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N Fee Current I Y / N <br /> Address I <br /> 1 <br /> License # <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address <br /> I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N Fee Current 1 Y / N <br /> Address <br /> I License # I <br /> OTHER <br /> Company <br /> Signature Registered Y / N J Fee Current I Y / N <br /> Addres <br /> - <br /> Directions: - . <br /> Fit 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 55000) <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 />