Laserfiche WebLink
s�3-7so-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application T o M ... jA tG � <br /> Date Received � - ' Phone Conta� ct_ f� or Permit ��� � +L( rL <br /> Owner's Name 2� (:G/It/N.pA7S L�-c.� er's Phone Number �� 3 �� Qd� <br /> Owner's Address 19"p�GIL`Q, L�/G ��� /} � <br /> Fee Simple Titleholder Name Titleholder Phone Number �� �� <br /> Fee Simple Titleholder Address <br /> Job Address plo /1�u- iCX-��• � �1 jLL� Lot # � <br /> Sub Division G.CjO/� t p�11v�Gr-�,� Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL a 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 �/ " I / / <br /> � Emergency Generator > 30 kw � LP/Naturai Gas-ANNUAL Sal� • ' <br /> � � <br /> Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL ��----- <br /> � emi �n er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum /� �� <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers �// <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations �' 1'`�emcdcL <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> n Fire Pumps � Waste Tire Storage ANNUAL <br /> U Fire Works <br /> Q Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor . Company A1 �s /Li �,r`� <br /> Signature Registered Y Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN 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 /> MECHANICA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> DirecGons: F r � . � � � , . � , ` <br /> Fill out application completely <br /> Owner 8 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 appiicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />