Laserfiche WebLink
813 -780 -0020 City of.Zephyrhills Fire j/' 0 ?/ Fax - 813 - 780 -0021 <br /> ' -Permit Application / <br /> Date Received t'e 121 l Phone Contact for Permit / 3 3.5" 34fA <br /> Owner's Name 1 P 14 1 X CoMfrts01$1 LLC 1 Owner's Phone Number <br /> 1 1 1 <br /> Owner's Address 7 7 7 G.L. 14 4 c O I 'RA/ kin 11.b}'1u -s C 'S 35" 4 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> /� <br /> Job Address �� Z ti �� LV0 �cs ia"v1- m-1-t-5 <br /> Lot* <br /> Sub Division '"^.C-n rtvyt. (.o 1.4140 A1S Parcel # ? S'.1 -S.. Li ©1 3 o - 00coo- Op4o <br /> Nom. visatamatzwassuisalussimataisansum <br /> El Bio-FlazardWasteStorage - ANNUAL pi Fumigation Tent <br /> I Comm Exhaust Kitchen Hood/Duct I-I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I Controlled Bum I Hood Installation <br /> pi Emergency Generator < 30 kw I LP /Natural Gas - Installation <br /> I1 Emergency Generator > 30 kw I LP /Natural Gas - ANNUAL Sale <br /> ri Fire Protection Maintenance - ANNUAL = Places of Assembly- ANNUAL <br /> L!iin !Semi' f j Other <br /> Sprinkler n ❑ ID n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I n Sparklers <br /> Hood Cleaning CI ❑ ❑ ❑ I I 7 Sprinkler System Installations <br /> Hood Suppression Ei ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> I—I Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> I - I Fire Pumps = Waste Tire Storage ANNUAL <br /> j ] Fire Works <br /> n Flammable Application- ANNUAL (12 I 000 '0 I Valuation of Project <br /> pi Fuel Tanks <br /> f Other: I (1.( 4.1 1 of et' «14-r' ib p .01 C3 L Pd, M Lt. 6i . <br /> Contractor / e = =a <br /> !� .. `t" ` " <br /> Company s Go 1) $ � � (K•) e--.5 ..n � C. <br /> ... , <br /> Signature <br /> Registered CP/ N j Fee Current I C,V/ N _ <br /> Address 1 510 C S 1 3. CoAtd(H.CJII.. R4144 ((LW) TPA i3IL /o License # 1 1404¢9,00J tat' 9 <br /> ELECTRICIAN <br /> Company <br /> Signature I Registered Y / N j Fee Current l Y / N <br /> Address I I License #. <br /> PLUMBER Company <br /> Signature Registered Y/ N j Fee Current l Y / N J <br /> Address I I . License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N l Fee Current I Y/ N j <br /> Address I I License # I <br /> OTHER <br /> Company <br /> Signature Registered Y/ N j Fee Current I Y/ N J <br /> Address 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: /lappraiser.pascogov.com) <br /> • <br /> • <br />