Laserfiche WebLink
813-780 -0020 City of Zephyrhills Fire Fax- 813-780 -0021 <br /> Permit Application f� ] � („�/ <br /> P hone Contact Permit Date Received � C� 7 <br /> • S' <br /> - ;�.= <br /> Owner's Name Lid:e*A crp I Owner's Phone Number 1 ( 1 1 <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number I 1 1 I <br /> Fee Simple Titleholder Address I <br /> // // • 74 6 BI • <br /> Job Address ( /1 r (i� /% Lot # 1 I <br /> Sub Division Parcel # <br /> I I Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> F Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum I I Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL I I Places of Assembly-ANNUAL n ❑ • ❑ ❑ ( , C Q . 0" 4 <br /> IUtnyl (Semi) FM Other .2 (7 l {{ <br /> Sprinkler I Recreational Bum i - A, -{� <br /> n ❑ • ❑ <br /> Fire Alarm ❑ I I I 1 Sparklers <br /> Hood Cleaning n ❑ • ❑ ❑ I I n Sprinkler System Installations I-C t " <br /> V r <br /> /( <br /> Hood Suppression V t ❑ .X ❑ I I ( I Standpipes (Sprinkler Sys) !f ✓ t <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle T <br /> n Fire Pumps n Waste Tire Storage ANNUAL - <br /> I I Fire Works <br /> 0 Flammable Application- ANNUAL I / 75 r cx - ( Valuation of Project <br /> Fuel Tanks <br /> In Other: I <br /> Contractor �`/ Company .3: /UG - p c/ J�- - pi r <br /> Signature / Registered Y / N I Fee Current Y / N / � �� <br /> I <br /> Address I L/7 OG Lc, � cc r r 11.4 11.4 tt' - - - 70-4 - P• 7 _ License # COO igeC c <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I I <br /> Address I <br /> 1 License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> MECHANICAL • Company <br /> Signature Registered Y/ N 1 Fee Current 11// N ] I <br /> Address I I License # I <br /> ,. <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I 1 <br /> Address <br /> 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 />