Laserfiche WebLink
813 80 -.0u. 1 City of.Zephyrhills Fire ] �1 �� Fax - 813780 -0021 <br /> 'Permit Application - ( V <br /> Date Received Phone Contact for Permit <br /> "`Owner's Name f /4 jeikl J Is 5 Owner's Phone Number L / G 1 . 415 7sy <br /> 4 Owner's Address 674 / 4 // / 6:4// / hl ` ✓/1 i f/ / / S ' J (T / <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitleholder Address I <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> < � A, �, a . y _,. .✓,,.. r _. .. P e _. 9 ,- vmF✓-i+k. <br /> n Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> I - 1 Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL - n Places of Assembly- ANNUAL <br /> Zan r €S7T rah Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ I I n Sparklers <br /> Hood Cleaning I ' ❑ V/ ❑ I I 7 Sprinkler System Installations <br /> Hood Suppression 0 ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> I Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> H I <br /> Flammable Application- ANNUAL 1 Valuation of Project <br /> Fuel Tanks <br /> 0 Other: I <br /> ISSINESSIMPROUSIMUNINEENT <br /> Contractor Company <br /> Signature 1:, Registered Y / N ] Fee Current I Y / N J <br /> Address I I License # I I <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N I Fee Current I Y/ N j <br /> Address I I License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N J Fee Current 1 Y/ N I <br /> Address I I . License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y / N j <br /> Address I I License # I <br /> OTHER Company <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 /> • <br />