Laserfiche WebLink
813-780-0020 City of Zephyrhills Fire 4 ((f 6 C� <br /> Pe rmit Application f J Fax- 813 780.0021 <br /> Date Received . <br /> `" "�` r L . ,: .....M._,. Phone Contact for Permit J <br /> Owner's Name ■ St Joseph's Catholic Church <br /> 1 Owner's Phone Number I 813 I 7 8 2 'z <br /> Owner's Address i 5316 1 1th St Zephyrhills Fl 32540 <br /> Fee Simple Titleholder Name I same ( <br /> Titleholder Phone Number I 1 <br /> Fee Simple Titleholder Address I <br /> Job Address I Church 5th Ave & 11th st Church Hall 5th ave tk� <br /> I I Lot # <br /> Sub Division I <br /> Parcel # <br /> n Bio- Hazard Waste Storage - ANNUAL r — <br /> ' I Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum ED Hood Installation <br /> Emergency Generator < 30 kw <br /> LP /Natural Gas - Installation <br /> • <br /> R Emergency Generator > 30 kw <br /> Fire Protection Maintenance - ANNUAL ED <br /> LP /Natural Gas - ANNUAL Sale <br /> Places of Assembly- ANNUAL <br /> Sprinkler ❑ ❑ ❑ <br /> "ice [rte raj lotner I <br /> El Recreational Bum <br /> Fire Alarm © ❑ ❑ X0 1 I <br /> ❑ I Sparklers <br /> Hood Cleaning ❑ ❑ ❑ J <br /> Sprinkler System Installations <br /> Hood Suppression 1=3 ❑ ❑ ❑ 1 I <br /> f ED Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation = Torch Roofing/Tar Kettle <br /> Fire Pumps a Waste Tire Storage ANNUAL. <br /> Fire Works <br /> Flammable Application- ANNUAL I <br /> Fuel Tanks $ 4 4 0. 0 0 I Valuation of Project <br /> [=3 Other: ! <br /> Contractor <br /> Signature <br /> Company <br /> Registered Y/ N 1 Fee Current ! Y/ N I <br /> Address 1 1 <br /> ELECTRICIAN --� 1 License # <br /> Signature -fC �� <br /> Company • <br /> Address I Thomas Boat Landing Rd Umatilla Ft License Fee Current `/ <br /> icense # ( EC EC 0002542 <br /> PLUMBER <br /> i Signature Company <br /> Registered Y/ N I Fee Current L Y / N <br /> Address ! I <br /> License # <br /> MECHANICAL! <br /> Signature I I Company <br /> Address I <br /> Registered Y / N 1 Fee Current 1 Y / N <br /> License # ! <br /> OTHER <br /> Signature I Company <br /> Address Registered Y/ N j Fee Current ! Y/ N <br /> Directions: License # <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) r1 <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 h : //a <br /> ( ttP' ppreiser.pascogov.com) <br />