Laserfiche WebLink
813-780-0020 /7JC = P' ' r^1K City of Zephyrhills Fire .. , ran-0 i rt ov-UUL <br /> __... 11 oloS ._.._.. - - Permit Application ! ~ � <br /> Date Received -' 2 `, ( Phone Contact for Permit 81� (a-1 Owners Name CIn(�, (Y J .UT SZt t/%Q. )#k-• I Owner's Phone Number l 1 I I I <br /> Owner's Address 3ey1 $ J!'1prfUC.161 5 Q&O zianlht'RH-kJS,PL• 33542. • <br /> Fee Simple Titleholder Name Titleholder Phone Number I <br /> Fee Simple Titleholder Addres <br /> Job Address 3805 mA 124.17:r squhlCk Lot# <br /> Sub Division Parcel # 07 ,L(,. ;► • 0010 • 0 350 ' OOZA <br /> ED Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> E Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I —I Controlled Bum n Hood Installation <br /> a Emergency Generator < 30 kw I-1 LP /Natural Gas - Installation <br /> nl Emergency Generator> 30 kw a LP/Natural Gas - ANNUAL Sale <br /> I -1 Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> r y ISemr ( [ga Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm El ❑ ❑ ❑ I I I I Sparklers <br /> Hood Cleaning El ❑ ❑ ❑ I I El Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL. <br /> Fire Works <br /> Flammable Application- ANNUAL <br /> 1A3.50 -151) ( Valuation of Project <br /> Fuel Tanks <br /> p Other: L O c,I4rt (,I t) c -i QG, ry s k S b C F IrLd serz-Armr-Ldh. <br /> Contractor Tc tt -'( -- r - - r . � _ Company f t Pr+ �r 1R- SlAWN)LU Inc-. ( <br /> Signature L— Registered CO/ N I Fee Current I (3)/ N 1 <br /> Address I 1 s License # I 4 1 R y g Z.o 60 t I g 44 I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N 1 Fee Current I Y / N <br /> Address I I License # I I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N 1 <br /> Address I I License # i <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current I Y/ N I <br /> Address I I License # 1 I <br /> OTHER Company <br /> Signature Registered Y/ N 1 Fee Current I Y / N j <br /> Address License # <br /> Directions: <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 />