10-10463 - Laserfiche WebLink

Browse Search

813-780 -0020 City of Zephyrhills - Fire. J Fax -813 - 780 -0021 Permit Application # I t _I . Date/Received` - .S` t'.V - aC 71 ‘ ) Phone Contact for Permit • / 3 4- 7f 1 C Owner's Name Owner's Phone Number I I I I Owner's Address Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address I Job Address A- f by J 7 6c-i !3/ d_ Lot # Sub Division Parcel # I Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent E Comm Exhaust Kitchen Hood /Duct f I Hazardous Material (Tier II or RQ Facility) ANNUAL I — I Controlled Bum I I Hood Installation I — I Emergency Generator < 30 kw n LP /Natural Gas - Installation I I Emergency Generator > 30 kw I I LP /Natural Gas - ANNUAL Sale [ ] Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL C'irai (Semi) I""' l Other Sprinkler ri ❑ ❑ ❑ I I Recreational Bum Fire Alarm IJ ❑ ❑ ❑ I 1 I I Sparklers Hood Cleaning VI ❑ ❑ ❑ I I I I Sprinkler System Installations Hood Suppression I Y r ❑ X ❑ I I I I Standpipes (Sprinkler Sys) El Fire Alarm Installation YY" n Torch Roofing/Tar Kettle JI Fire Pumps El Waste Tire Storage ANNUAL Fire Works I-7 Flammable Application - ANNUAL ( / 75:4't.5 ( Valuation of Project ( Fuel Tanks rI Other: I I anseasissismatir ___ ATV Contractor mpan N Fee C IJ Signature Co yd g urrent I Y/ N I Address I '17Q1 O G - - L i 6 - r 6 i t - r e — Tare....,_ .n I License # E p /6 , 32 / c - O ! Z,e ' 9 ELECTRICIAN Company I Signature Registered Y/ N I Fee Current I Y/ N J Address ( I License # I PLUMBER Company Signature Registered Y/ N 1 Fee Current I Y/ N I Address I I License # I MECHANICAL Company Signature Registered Y/ N I Fee Current 1 Y/ N, Address 1 I License # a OTHER Company Signature Registered Y/ N I Fee Current I Y/ N Address iszw, License # Directions: Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) tf 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)