Laserfiche WebLink
813-780-0020 City of.Zephyrhills -Fire Fax- 813780 -0021 <br /> Permit Application <br /> Date Received M I ` Phone Contact for Permit <br /> ,4 <br /> /� _�`` _ <br /> Owner's Name h25 A edS Owner's Phone Number . cP 1 98a 1 1 66` , I <br /> Owner's Address 38',300 /J Z y ,.. %f/ rL . <br /> Fee Simple Titleholder Name I Titleholder Phone Number <br /> Fee Simple Titleholder Address 1 <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum 17 Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw 1 1 LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> IUtrlyI Jsemi1 Jfl other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 11 1 Sparklers <br /> Hood Cleaning ® )( ❑ ❑ I 1 n Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ ❑ 1 I n Standpipes (Sprinkler Sys) <br /> n Fire Alarrn Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application- ANNUAL I ( Valuation of Project <br /> FT Fuel Tanks <br /> n Other: 1 <br /> Contractor Company 1 <br /> Signature Registered Y / N Fee Current 1 Y / N <br /> Address ( 1 License # 1 1 <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N ] Fee Current 1 Y / N 1 <br /> Address 1 <br /> 1 License # 1 <br /> PLUMBER Company 1 <br /> Signature Registered Y / N j Fee Current 1 Y/ N 1 <br /> Address 1 1 License # 1 1 <br /> MECHANICAL Company <br /> Signature Registered Y / N Fee Current 1 Y / N j <br /> Address 1 1 License # 1 1 <br /> ` <br /> OTHER Company SL:///` /" Jr F er IAwr - ,./7 dL.L 1 <br /> Signature /r' Registered N Fee Current �`) N <br /> Address vv <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 (http: / /appraiser.pascogov.com) <br />