Laserfiche WebLink
813 -780 -0020 'City of.Zephyrhills Fire Fax - 813 - 780 -0021 <br /> Permit Application <br /> Date Received � - Z. 0 - / 0 Phone Contact for Permit <br /> szotbroso <br /> Owner's Name /4 C 0 Se-L-4— Owner's Phone Number <br /> Owner's Address <br /> 73/ 3 � 1Y /L f . b . Z N7- }1 LLf /` / . <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple - titleholder Address 1 <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> 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 /> Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL Places of Assembly- ANNUAL <br /> IlItTyl !Semi j Other <br /> Sprinkler n ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps = Waste Tire Storage ANNUAL <br /> n Fire Works <br /> E Flammable Application- ANNUAL ` I Valuation of Project <br /> n Fuel Tanks <br /> FT Other. I <br /> �. . - _,.. <br /> Contractor �/ Company <br /> Signature 4 /•� <br /> % (l 1 Registered Y/ N J Fee Current 1 Y/ N <br /> Address I License # I J <br /> ELECTRICIAN Company <br /> Signature I Registered Y / N J Fee Current I Y / N j <br /> Address l I License #. <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address 1 I ' License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N J Fee Current I Y / N I <br /> Address I 1 License # <br /> OTHER <br /> Company <br /> Signature Registered Y / N I Fee Current I Y / N 1 <br /> Address ewe, License # <br /> Directions: <br /> • <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 />