Laserfiche WebLink
813-780 -0020 City of.Zephyrhills 4 Fax -813- 780 -0021 <br /> Permit Application _ <br /> Date Received , 207 <br /> . + <br /> Phone Contact for Permit 7 zi <br /> Owners Name 07 eli Doili/¢ LDS - Owner's Phone Number 7Z7 I 2,0 7 la/ b( <br /> Owner (t s Address '042 6 42t &Vf . < •Z ! 1 01-1 y 4 d/t, , 3354 / <br /> Fee Simple Name ! Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address (0 09 Z 64 L L /p. • i ,,, a s pti R5 Lot # <br /> Sub Division Parcel # <br /> n Bio -Hazard Waste Storage – ANNUAL n Fumigation Tent <br /> El Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL <br /> r y ISemi 1 gaj tither <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning I v___,E1 IBS / ❑ ❑ I 7 Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ 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 /> H Flammable Application- ANNUAL I ( Valuation of Project <br /> Fuel Tanks <br /> n Other: I I <br /> Contractor Company I <br /> Signature Registered Y / N j Fee Current I Y/ N I <br /> Address I License # I <br /> ELECTRICIAN Company I <br /> Signature Registered Y / N 1 Fee Current I Y/ N I <br /> Address I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address I 1 License # I I <br /> MECHANICAL Company I <br /> Signature Registered Y / N 1 Fee Current I Y / N j <br /> Address I I License # I <br /> OTHER Company itiffll SegViCCS /r%' C I <br /> Signature Registered Y / N Fee Current Y / N <br /> Address igMT t, /7 /Mi i License # <br /> a.,y„'.e vSPE. 3. ,y.z: "1t "L 3SN �f"',4 53#D'�,._.. _ _. -_ fiP',.� Pb_ . .xee..... ,tt..,, ✓.. ....?n- _- AV- 'Sm.'.*+r 444 ..."',4 '! "! x.. ,'a '042 A..04' '*7 . .._.,4 . . . .. .. .. ,nv... .7 0 4.:,774`:.'.'.�i <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> tf 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 l /appraiser.pascogov.com) <br />