|
813-780-0020 City of.Zephyrhills Fire w s Fax- 813 - 780 -0021
<br /> /
<br /> Permit Application f � X lY
<br /> Date Received l I Phone Contact for Permit J 11 J
<br /> ,.aa: s: ,r:.,�o.'✓S, =F:v,3.,.,ws ,..xi.w >.w,> . ,.. ` ..,T ' c, rws„ zu.. ..x..,s�•.x+zx„aa'�° N L. we4 sx: u' � " „ .: SFA 54' at za35' e. a.. a'=.. ar ss ....w,..s . ».,.,...,..» c..,,n..n..na ,.. ,...,,.u_A
<br /> Owner's Name ZEP ` h1 8-1-44 1 .. I" lt,6 AL 3354 U 6K.../L►�, y Owner's Phone Number
<br /> Owner's Address 5? 6 5f. Zt'� °Z"
<br /> Fee Simple Titleholder Name Titleholder Phone Number
<br /> Fee SimpleTitteholder Address I I
<br /> „ ;:',M a.. ,Ab'a. - : c '. < . re ai" AWN t . `+;:fkzf:`. '7�..*n,..a ;N NRO :;.:: A%....'a. EV . :. . ' V,,4 ;;a 14i,: •z 'v, a..:. I= .ilimm rav,,,.;a:
<br /> Job Address Lot #
<br /> Sub Division Parcel #
<br /> .... ': ? : :''..M .: u.:I I x •:. n "ld, '.. sue:,. ate ' , , ' ' * 'Kxf .« ..M t;°N'. "' '"d M, , : ° .., ,°;4=0',,e :,A AVOMF ,5a. «.t una;" . u i ,162Vau.,. is ;, -!.
<br /> I Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent
<br /> I] Comm Exhaust Kitchen Hood /Duct r Hazardous Material (Tier II or RQ Facility) ANNUAL
<br /> Controlled Bum n Hood Installation
<br /> Emergency Generator < 30 kw I LP /Natural Gas - Installation
<br /> I — I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale
<br /> I F ire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL
<br /> ILItrlyj !Semi FFil Other
<br /> Sprinkler n ❑ ❑ ❑ I Recreational Bum
<br /> Fire Alarm IT ❑ ❑ ❑ J 1 1 1 Sparklers
<br /> Hood Cleaning I ❑ ❑ ❑ ( 1 n Sprinkler System Installations
<br /> Hood Suppression D ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys)
<br /> JJ F ire Alarm Installation n Torch Roofing/Tar Kettle
<br /> I Fire Pumps I Waste Tire Storage ANNUAL
<br /> I —
<br /> I Fire Works
<br /> n Flammable Application- ANNUAL J Valuation of Project
<br /> ri Fuel Tanks
<br /> t l O ther: I I
<br /> Contractor Company
<br /> Signature �� l/ � `� VYL/ Registered Y / N ] Fee Current I Y / N
<br /> Address I I License # I I
<br /> ELECTRICIAN Company I
<br /> Signature I Registered Y/ N I Fee Current I Y/ N 1
<br /> Address I ( License # I
<br /> PLUMBER Company I
<br /> Signature Registered Y/ N 1 Fee Current I Y/ N I
<br /> Address I I License # I I
<br /> MECHANICAL Company I
<br /> Signature Registered Y/ N 1 Fee Current I Y/ N I
<br /> Address I I License # ( I
<br /> OTHER Company I
<br /> Signature Registered Y/ N ] Fee Current I Y / N I
<br /> Address I I License #
<br /> 4 &3 K-, .ee,.,,,:�w.. r�c taz as ..a.,,...usaw:,:,, ac . .. • . ,,,;u s -„ '.rr as v,.rweza.. wa.,,a..w.,vm a•.
<br /> '�, `` ism,esm .< n....,.,.. «,�a�sr:w_.,.MSRV;
<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 />
|