Laserfiche WebLink
813-780 -0220 City of Zephyrhills 'Fire. Fax- 813-780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> .. ,,.. <br /> Owner's Name JQ ('I(' (} Ra Lam. Owner's Phone Number I I I I_..I <br /> Owner's Address 7 SJ 0 itn 4 JJ */ rnIZi AA ,al4C4. a y /kPlaD / PY- 14A 5'aMa- <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> .. .,, .., , ",'S.x... ',i's ,.�. a. TADV Via. _` E s a : z •r Job Address 7 6i*i. SEA • l r�.I�yA v)e.C.� J k.• Lot # <br /> � <br /> Sub Division [ 3 4/4 <br /> Parcel # L/ • Ov /v • ValqV • apsJ <br /> ==a..Z._«,4-tV6_.w�.��'+;aa.. e.kw., t .ter,. ,_,: i ::w. Fs a4k..� •::.: <br /> I Bio- Hazard Waste Storage - ANNUAL 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 1 Hood Installation <br /> I I Emergency Generator < 30 kw I I LP /Natural Gas - Installation <br /> Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> I Utrly1 `Semi l rA7111 Other <br /> Sprinkler / 6 ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ I I Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I Sprinkler System Installations <br /> Hood Suppression 1 1 ❑ ❑ ❑ I I 1 Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> I I Fire Pumps I I Waste Tire Storage ANNUAL <br /> I Fire Works <br /> Flammable Application- ANNUAL I, e4r 0. I Valuation of Project <br /> I 1 Fuel Tanks � <br /> n Other: I <br /> " _.,..:'. 1.2 :::.:..:::..,+a..vig ::::, -a; TMLAW24..uc" ,ea+; iWiT�.S.A "a ilaie iL: r aP.kaanom.,. <:.fi ..:tl...u. 2iL 3 . «s ,mot M , 53 <br /> Contractor .,,..., <br /> Company I <br /> Signature Registered Y / N Fee Current I Y/ N I <br /> Address I I License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current 1 Y / N, <br /> Address ( <br /> 1 License # <br /> PLUMBER , I. Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature y Registered Y / N _ Fee Current 1 Y / N <br /> Address <br /> License # <br /> OTI-18 Company Attofru fi #14 A 41tS itiC. <br /> SignatLr Registered WI N !( Fee Current Y / N <br /> Address 1 tSV/ T <br /> IQK • 'S�(i /g I Licensee °/ <br /> l 4/6 B ySe /�7S <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 />