Laserfiche WebLink
813 - 780 -0020 City of Zephyrhills Fire Fax - 813- 780-0021 <br /> Permit Application <br /> Date Receive Permit I I I (I <br /> r ... 1 P hone Contact for erm <br /> Owner's Name l j r✓ e 4..r✓ n O F e_ vk\. I Owner's Phone Number I ( r'-- 11 78 D 1 74 <br /> Owner's Address 3 (0--1-'0 14-1": \i D ✓(_ <br /> Fee Simple Titleholder Name (Sef-/"( Titleholder Phone Number I 1 1 I I <br /> Fee Simple Titleholder Address <br /> Job Address I <br /> Lot # <br /> Sub Division I Parcel # I <br /> El Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> i Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Bum n Hood Installation <br /> F - 1 Emergency Generator < 30 kw a LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> El Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> ❑ Ininj emi 0,1 Other <br /> Sprinkler ❑ ❑ ❑ IT Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I ( n Sparklers <br /> Hood Cleaning 0 ❑ ❑ ❑ I 1 n Sprinkler System Installations <br /> Hood Suppression 121 -lf ❑ I ( n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application- ANNUAL 1 / d 0 J..5-e., I Valuation of Project <br /> Fuel Tanks <br /> 0 Other. I <br /> Contractor <br /> Signature � ���� v'' � � `e- Company IADIE ! 1 <br /> t' Registered Fee Current Y / N <br /> Address 1'79 ? (1 • 40a 5,1+3 A I it- 140N(0 ' 3 4 `P? 7 I License # I fJal 00 x Q.'? Y? I <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> PLUMBER <br /> Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> OTHER <br /> Company <br /> Signature Registered Y/ N _I Fee Current I Y/ N I <br /> Address I I License # I <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: / /appraiser.pascogov.com) <br />