Laserfiche WebLink
• <br /> 813 - 780-0020 City of Zephyrhills•Fir`B, Fax -813- 780 -0021 <br /> Permit Application - - <br /> )ate Received Phone Contact for Permit <br /> )wner's Name 1 ' 1 n c--1-,as e n s B l u l'• I r Owner's Phone Number 1V/3 1 / k� • 16-5/j )wner's Address a I � L St A. . 1 0 d Z 9 Y(' h'' 1 15 J - F 1 3 3 S4/.� <br /> =ee Simple Titleholder Name <br /> I Titleholder Phone Number I I , , J <br /> p Titleholder Address I <br /> =ee Simple ._... <br /> Job Address l..e 25 l (0 6-a, s Iv v . r r °, 1 335 — Lot # may <br /> Sub Division L. • 2 ' • L... C A., 11 s Parcel # b d4 at/ QV/V 0)'Lio - Ot7aO <br /> ri ,. . .... -: z .. , .. <br /> Bio- Hazard Waste Storage - ANNUAL Fumigation Tent <br /> CI Comm Exhaust Kitchen Hood/Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> Emergency Generator < 30 kw n LP /Natural Gas - Installation .' <br /> Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale ` <br /> I Fire Protection Maintenance - ANNUAL 1 Places of Assembly- ANNUAL �' (o <br /> L r3r 4 J Other D <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ X I I n Sparklers <br /> Hood Cleaning LI ❑ ❑ ❑ I 1 I Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ ❑ I 1 1 I Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL ! Valuation of Project <br /> Fuel Tanks <br /> n Other: 1 <br /> . <br /> Contractor <br /> Company L • 11 d s 1 <br /> Signature i ! Registered j] fee Current ro <br /> Address ' tl ow• - - • I , C • License # 1 E' - 1000 J)-1 co I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N Fee Current Y / N <br /> Address 1 I License # I <br /> PLUMBER Company <br /> Signature Registered Y / N Fee Current Y / N <br /> Address 1 I License # I <br /> MECHANICAL Company 1 <br /> Signature Registered Y / N l Fee Current 1 Y/ N I <br /> Address I I License # I <br /> OTHER Company <br /> Signature • Registered Y / N Fee Current Y / N <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 />