Laserfiche WebLink
813'50 -00Z City of.ZephyrhillsFire• Fax - 813-780 -0021 <br /> Permit Application <br /> Date Received I Pho f <br /> ne Contact for Permit <br /> . .,;•.,,e. - a.�.n., .,., _ <br /> g 13 1 S4 <br /> Owner's Name e.._-45-2_ C_o Hog o Q V 7 TT Owner's Phone Number 813 s ' - s 1 6 S / <br /> Owner's Address 7. 0 11.0 973e TAN PTA , L 3 3 6 7 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address 40M/ �P S p/7 2_71 -- v ^moo GAL t AL Lot <br /> Sub Division Parcel # <br /> n Bio- Hazard Waste Storage n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct I I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum I Hood Installation <br /> n Emergency Generator < 30 kw • I LP /Natural Gas - Installation <br /> I I Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> I(.ttrlyl Ibemi ) IAni I Other <br /> Sprinkler n ❑ ❑ ❑ 1 I Recreational Bum <br /> Fire Alarm I ❑ ❑ ❑ I . I I ( Sparklers <br /> Hood Cleaning J ❑ v ❑ 1 1 1 I Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ I I 1 I Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation . n Torch Roofing/Tar Kettle <br /> I Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL 1 I Valuation of Project <br /> I I Fuel Tanks <br /> I Other I �,. ..,r.._ . <br /> .<a @�:, �*it 0.�.R ..�::._... ...- . .�� �:.�.,..,�. -. „�, -.y. ,,. +, .� -•-s ,.,- <'r' -. . .,. .. :._; r ..II^.�tk ....�:�,.. „�:a v_xR.�:- �.:,..- ,�,...r i. ,.,r.. _. __,::v: <br /> Contractor Company <br /> Signature � F Registered Y / N Fee Current Y / N <br /> Address I I License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N I Fee Current 1 Y / N I <br /> Address 1 I License # I <br /> PLUMBER Company I <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address I I License # I I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I I <br /> OTHER Company I <br /> Signature , Registered Y/ N I Fee Current I Y/ N I <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 (http: / /appraiser.pascogov.com) <br />