Laserfiche WebLink
813- 780 -0020 City of Zephyrhills Fire Fax- 813- 780 -0021 <br /> Permit Application <br /> Date <br /> _.1- <br /> ceived a L.._ 1 Phone Contact for Permit I I I I I <br /> • Owners Name '^ i� : �rlr„..-...AN-V"...1.11 hers Phone Number I 1 1 I I <br /> • ."Owner's Address I 7 9 '. ' '.3 ,c = ' T/ ` - C_/' I <br /> I I Fee Simple Titleholder Name j Titleholder Phone Number <br /> Fee Simple Titleholder Address I l <br /> Job Address Lot # <br /> Sub Division I Parcel # I ( <br /> E Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct = Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> Emergency Generator > 30 kw LP /Natural Gas - ANNUAL Sale <br /> a Fire Protection Maintenance - ANNUAL 'l Places of Assembly- ANNUAL <br /> rafTyl 1 emi (;J Other <br /> Sprinkler E ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm 1=1 ❑ ❑ ❑ ( I n Sparklers <br /> Hood Cleaning E ❑ ❑ ❑ l ( Ej Sprinkler System Installations <br /> Hood Suppression Ej ❑ ❑ ❑ I I = Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> El Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I ( Valuation of Project <br /> Fuel Tanks <br /> 0 Other: I <br /> r bontractor Company l <br /> Signature � � � / Z � � / Registered Y/ N I Fee Current I Y/ N I <br /> Addre <br /> I License # <br /> ELECTRICIAN Company l <br /> Signature 1 Registered Y/ N I Fee Current I Y/ N I <br /> Address I 1 License # 1 l <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address l I License # I I <br /> MECHANICAL Company l <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I l <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N I <br /> Address l 1 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 />