10-11246 - Laserfiche WebLink

Browse Search

813 -780 -0020 City of Zephyrhills Fire cgtli Fax -813- 780 -0021 Permit Application Dave Received I I Phone Contact for Permit I} 2 111411 I I I q Q3 Owner's Name 1 TP.,,,,-, rn /U` / /v7 k V , / 1 Owner's Phone Number I V ? (I m 1 079, I Owner's Address 3q 60. flie Ay,9 fc& 4 n P ,� /S - 35 /i Fee Simple Titleholder Name I ( I r - y Titleholder Phone Number L , I I I Fee Simple Titleholder Address I 3 9 6 0 a 474/p40____t ! / I Lot # I , Job Address ( � � � to t,‘ r S �/ 3 35Y1./ Sub Division I I I / Parcel # I I I Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL r Comm Exhaust Kitchen Hood /Duct n Hood Installation ri Controlled Burn LP /Natural Gas - Installation F - 7 Emergency Generator < 30 kw I I LP /Natural Gas - ANNUAL Sale I I Emergency Generator> 30 kw I I Places of Assembly- ANNUAL [?5_1 Fire Protection Maintenance - ANNUAL 71 Recreationel Burn IQtrlyl Feral ter 1 Sprinkler n ❑ ❑ Sparklers Fire Alarm 1 ❑ ❑ ❑ I - 1 I I Sprinkler System Installations Hood Cleaning ❑ ❑ ❑ III I Standpipes (Sprinkler Sys) Hood Suppression n ❑ ❑ ❑ I I I I Torch Roofing/Tar Kettle Fire Alarm Installation n Waste Tire Storage ANNUAL n F - ire Pumps pi F - ire Works I 1 Flammable Application- ANNUAL 1 j Valuation of Project F uel Tanks ®, Other: I eaC K -rimA, 1 Contractor ___i Signature ' �, Company I A - I g (u�i o 4 Registered Y/ N Fee Current 7 Y/ N I Address 3531 V, �ko „e, I I ,2 3530000 laooz I License # Q ELECTRICIAN' I Company Signature Registered Y/ N I Fee Current 1 Y/ N I Address I 1 License # I I PLUMBER I _� — Address I Company J Signature Registered Y/ N Fee Current I Y / N 1 I License # I MECHANICAL' I Company Signature Registered Y/ N j Fee Current I Y/ N I Address I I License # I OTHER 1 I Company I Signature ' Registered Y/ N I Fee Current I Y/ N I Address 1 I License # I J Directions: Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)