Laserfiche WebLink
813-780 -0020 City of Zephyrhills Fire ill (o Fax 813 -780-0021 <br /> Permit Application I <br /> )ate Received ..l ..f J Phone Contact for Permit <br /> )wners Name ! P. 6_6 A c_. 1 b,v / it/UN, e,,,,,, l Owner's Phone Number <br /> { ] I L <br /> )wnersAddress 42 ZI5 h , /Lf XM-176-r ' 'c in (' <br /> vo <br /> :ee Simple Titleholder Name 1 I Titleholder Phone Number ( I I <br /> :ea Simple Titleholder Address I <br /> Job Address (a 2 / 3 --- /9-&/-/- )/ 1- d ,V 42 v,C Lot # ` <br /> Sub Division Parcel # <br /> .. - ...z_. F umigation <br /> n Bio- Hazard Waste Storage - ANNUAL En Tent <br /> . n Comm Exhaust Kitchen Hood/Duct 1 Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw LP /Natural Gas - Installation <br /> E l Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance -ANNUAL = Places of Assembly ANNUAL <br /> •L ji Semi tither <br /> Sprinkler ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I IT Sparklers <br /> Hood Cleaning ❑ ❑ ❑ ❑ I 1 n SprinlderSystem Installations <br /> Hood Suppression E ❑ ❑ ❑ I I Standpipes (Sprinkler Sys) <br /> ® Fire Alarm Installation In Torch. RoofingfTar Kettle <br /> Id <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Fire Works • <br /> Flammable Application- ANNUAL <br /> 1 gee' ° — ) I Valuation of Project <br /> Fuel Tanks <br /> ® Other. I.5 5-/ e^n Fx 40/ otti Pt- it_ 5 c u® Le j /rte <br /> Contractor <br /> Signature <br /> Company <br /> Registered Y / N Fee Current Y / N <br /> Address I <br /> 1 License # I <br /> ELECTRICIAN ` 1 <br /> Signature ll ,-------- 11 i � a ��L{ <br /> Company '!� L �pn k"-,..5 i � <br /> Registered Imam Fee Current li N <br /> Address I .3 79 /7 /i/rq/, eA ?rte Z A License # <br /> PLUMBER <br /> 1 FF 6C0/c� <br /> Signature Company <br /> Registered Y / N Fee Current Y / N <br /> Address I I <br /> License # 1 <br /> MECHANICAL' 1 <br /> Signature Y z p` <br /> I�j" � � Company <br /> Y 1J ,D egistered Y/ N I Fee Current I Y/ N I <br /> Address grte mAV <br /> OTHER ` , <br /> Signature ..,�� J , _,, , ' . e ., .: <br /> es �!,�' �- <br /> 9Yr+ i Fee Current Y / N <br /> Address I �_ <br /> rn �i , r <br /> /�/y' <br /> ,iaV�' <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> • <br /> If over 52500, 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 />