10-10765 - Laserfiche WebLink

Browse Search

813- 780 -0020 City of.Zephyrhills Fire Fax- 8137ao -oo21 Permit Application Date Received J 2 Z2—/ O 4 er+ Phone Contact for Permit . 1 6/3 996 , 164'6f 1 Owner's Name J gar Afft L'4‘,"246.4 b- 2 rhiy ( Owner's Phone Number _ Owner's Address 3 5 2 3/ r� =— J i/'e_ 2#;//5 3 3,5 2-- Fee Simple Titleholder Name Titleholder Phone Number Fee SimpleTitieholder Address I I Job Address 3W 2 -3 / 5741 47,-e ✓ 35 Lott Sub Division Parcel# Bio-Hazard Waste Storage - ANNUAL = Hazardous Material (Tier II or RQ Facility) ANNUAL n Comm Exhaust Kitchen Hood/Duct = Hood Installation Controlled Burn n LP /Natural Gas - Installation I - I Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale jg Emergency Generator> 30 kw of Assembly-ANNUAL Fire Protection Maintenance - ANNUAL n Recreational Burn try )Semi Other Sprinkler E ❑ ❑ ❑ 1 Sparklers Fire Alarm E ❑ ❑ ❑ 1 1 n Sprinkler System Installations Hood Cleaning El ❑ ❑ ❑ 1 1 ED Standpipes (Sprinkler Sys) Hood Suppression ® ❑ X ❑ J 1 ED Torch Roofing/Tar Kettle n Fire Alarm Installation = Waste Tire Storage ANNUAL I -1 Fire Pumps Fire Works n Flammable Application- ANNUAL f 1 c 0 1 Valuation of Project Fuel Tanks Ej Other: I Contractor �� Company Pi tC )FA ft/' /er L Signature c�� Registered Y / N I Fee Current Y / N Address o o_ •Ilir. • , ^ if _ License # ELECTRICIAN Company I Signature Registered Y/ N j Fee Current I Y/ N I Address I I License # I PLUMBER Company Signature Registered Y/ N 1 Fee Current I Y / N I Address I I License # I MECHANICAL Company I Signature Registered Y/ N 1 Fee Current I Y/ N 1 Address I I License# I I OTHER Company I Signature Registered Y/ N 1 Fee Current I Y / N 1 Address License # Directions: Fit out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10 - 14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)