Laserfiche WebLink
813-780 -0020 City of.Zephyrhills Fire 4 (72x - 813780 -0021 <br /> w Permit Application l <br /> Date Received Phone Contact for Permit <br /> Owner's Name • A _ L i ' _ �._ 4 .. S e%Dp , 4e%' Owner's Phone Number =2/6 1,,,,?/' 1 9 <br /> Owner's Address 3 . ' 1 l - - i ; _ / ` .am.' 1— //tar.I-1=01r.111w <br /> Fee Simple Titleholder Name Titleholder Phone Number I 1 1 1 1 <br /> Fee SimpleTitleholder Address I <br /> Job Address .39o2 T a ' S. AJe ZC-P7,6/oeif Z & / �'c ,. 57 ,1/j Lot # I <br /> Sub Division Parcel # <br /> Bio-Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> l Comm Exhaust Kitchen Hood/Duct I-1 Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum FT Hood Installation <br /> n Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> nI Emergency Generator> 30 kw p LP /Natural Gas - ANNUAL Sale <br /> I — I Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL <br /> IZTEY1 (Semi raj Other • <br /> Sprinkler ni ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ 1 n Sparklers <br /> I I <br /> Hood Cleaning ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression 0 ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> rI Fire Alarrn Installation I-I Torch Roofing/Tar Kettle <br /> El Fire Pumps I Waste Tire Storage ANNUAL <br /> ri Fire Works <br /> n Flammable Application- ANNUAL I I Valuation of Project <br /> rI Fuel Tanks <br /> Q Other. I <br /> Contractor �o/ Company tip <br /> Signature / Registered Y / N Fee I ee Current I Y / N <br /> Address i I License # I <br /> ELECTRICIAN Company <br /> Signature I Registered I Y/ N J Fee Current I Y / N i <br /> Address I I License #. I <br /> PLUMBER Company <br /> Signature • Registered I Y/ N I Fee Current I Y/ N <br /> Address I I • License # I <br /> MECHANICAL Company <br /> Signature Registered I Y/ N I Fee Current I Y/ N J <br /> Address I I License # <br /> OTHER Company <br /> Signature Registered I Y/ N J Fee Current I Y/ N <br /> Address License # <br /> Directions: <br /> r <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 />