Laserfiche WebLink
e� 3aso-on,2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received C( Phone Contact for Permit 8 l 3 �'(8 � ��� <br /> Owner's Name ti � � —(, S — � (` ,r�,✓�o pw�ers Phone Number � � � <br /> Owner's Address <br /> Fee Simple Titieholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> Job Address � �� � � t1�. � l � � � Lot # � <br /> Sub Division Paroel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL ,,/; <br /> �y emi �n er `� /�1 <br /> � J 1 <br /> Sprinkler � O ❑ O � Recreationai Bum <br /> Fire Alarm � ❑ ❑ ❑ � � � <br /> Hood Cleaning � ❑ ❑ ❑� Sprinkler System Installations <br /> Hood Suppression � p ❑ ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> a Flammable Application- ANNUAL 2'3 � Valuation of Project <br /> Fuel Tanks <br /> Q Other: 0 �� 1 L za, � G o <br /> Contractor Company �S'��. � n � � t..` , <br /> Signature Registered N Fee Current Y/ N <br /> Address (�. Q�p a License # 26�c.� H'LO �� l t 9 <br /> ELECTRICIAN �� �� � � Sa�S � �'� —�� � � Company <br /> Signature � ) Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <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 Mro (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 />