Laserfiche WebLink
813-780-0020 City ofZephyrhills'FirE; - :! • Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> Owner's Name T _ f r.. r *. I _ 1.1._. A 4604 Owners Phone Number . D 133 .39,5" 64 <br /> Owners Address 3141+ -E0 Lt ,eI, j4-tt 25 ! v yl u tt5� PL.., 335 a- <br /> Fee SimpleTitleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> n Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> 1 Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Burn n Hood Installation <br /> n Emergency Generator < 30 kw n LP/Natural Gas - Installation <br /> 1 I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> I I Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL <br /> ILItnyl 'berm' ma utner <br /> . El <br /> Sprinkler ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm E ❑ ❑ ❑ I . ( I Sparklers <br /> Hood Cleaning El ❑ ❑ ❑ I n Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ ❑ i 1 n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> I Flammable Application- ANNUAL 1 ( Valuation of Project <br /> I Fuel Tanks <br /> n Other: I II <br /> .�.,E.....:.� y._.. <br /> Contractor /' Company <br /> Signature 4' Registered Y / N I Fee Current 1 Y / N <br /> Address I License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current 1 Y / N 1 <br /> Address 1 I License # <br /> PLUMBER Company <br /> Signature Registered Y / N I Fee Current I Y / N j <br /> Address 1 1 License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current 1 Y / N <br /> Address 1 1 License # <br /> OTHER Company <br /> Signature Registered Y/ N 1 Fee Current 1 Y / N j <br /> Address _ License # <br /> - <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 />