Laserfiche WebLink
813-780 -0020 City of Zephyrhills Fire ' 1 21 % Fax - 813-780 -0021 . ' tr Permit Application l _ . <br /> Date Receive } 1 2 Z" tb Phone Contact for Permit if / 3 <br /> ..."'.'..".'.:'k.Xt�'<. . . «...ws✓ws.,.k.,.amw.wm.arrsAc•r g: „< sva4 � � , a „ ._;:nor <br /> Owner's Name 7 b r , y i' h e Gtr R e7C'�Qi Lc_ C Owner's Phone Number <br /> Owner's Address '7 a , 5 kk 11 DC k-eio exiv IYX O (et. CyNW yo1 j A4 /s6W -; <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address - 5 &a_ LL L Vd • Lot # <br /> Sub Division Parcel # 35 25- . - -00I0 - erao 0 -Jai a <br /> Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct 1 I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I I Controlled Bum I I Hood Installation <br /> I 1 Emergency Generator < 30 kw I ( LP /Natural Gas - Installation <br /> El Emergency Generator > 30 kw I ( LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL I I Places of Assembly- ANNUAL <br /> Iutrlyl !berm' (ATi Uther <br /> Sprinkler n ❑ ❑ ❑ ( I Recreational Bum <br /> Fire Alarm (—) ❑ ❑ ❑ I I l Sparklers <br /> Hood Cleaning I ❑ ❑ ❑ I Sprinkler System Installations <br /> Hood Suppression I ❑ ❑ ❑ Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps 1 1 Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I ( Valuation of Project <br /> Fuel Tanks <br /> Other: 1111117:41ral �'V %V <br /> 1 v :.,. x 3 =._a:.a,�K.a4'� N a d: <br /> Contractor , 0 Company Tr � r frelvbA S Ves4t <br /> Signature II .. A (/ V t Registered Y / N F f? Fee Current I Y / N <br /> Add - 5 0 a ._ B(,A)TNIatN.e b4 . - 7 1 License# I 1 miS % a- 76 Ooei=oo7 <br /> ELECTRIC • N Company I <br /> Signature Registered - Y/ N 1 Fee Current I Y / N <br /> Address I I License # I <br /> PLUMBER Company <br /> Signature Registered _ Y/ N I Fee Current l Y/ N I <br /> Address I I License # ( <br /> MECHANICAL Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N <br /> Address I I License # <br /> OTHER //(,(�, ,, A • Company ,ET AT�_.� <br /> Signatur= C A/° "_ Y Registered Y / N Fee Current Y / N <br /> Ad. ress • c9 ,J S let_ _, , . P.: f-- tg g a13 t aov 7 <br /> T' L i cense # <br /> ,. ....,. ,. .. .... - <br /> Direction <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: / /appraiser.pascogov.com) <br />