Laserfiche WebLink
813=780-002D City of.Zephyrhills Fire Fax-813780-0021 <br /> 'Permit Application <br /> � J �� <br /> Date Received Phone Contact for Pertnit <br /> ;r,r:':�"�.*B+r..�'x�:�zr�.xa.:..k.,.;...,...�..�:.: �.,�..�».,..�».. . .. . ,A... ..�,,.,.,M..�.�..�...�..�.,�»_.�.�......e,,..�.. <br /> Owner's Name ^ f � Owner's Phone Number �� �� I 4 9`� '7 I <br /> n �i1�,LL! J <br /> Owner's Address �� � � L � Z- -P yl� �..rG� [,. .. <br /> Fee Simple Titleholder Name TiUeholder Phone Number �� �� <br /> Fee Simple�TitleholderAddress <br /> 'a. > <br /> Jab Address � � (J � � LS �G Lot # � <br /> Sub Division Parcel # <br /> ae , <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent Y <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier il or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generetor < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sal r) I <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly ANNU L �� J l � <br /> � emi � er <br /> Spnnkler � ❑ ❑ ❑ � � Recreatio�al Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers " <br /> Hood Cleaning ❑ �C[ ❑� � Sprinkler System Installations <br /> Hood Suppression ❑ D ❑� � Standpipes (Sprinkler 5ys) <br /> a Fire Alartn Installation � Toroh Roofingrfar Kettle <br /> � Fire Pumps � Waste Tire Storege ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL /S', (P Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> z:?��s� . <br /> Contractor � Company F$. IZ L -' �'vE 7'.,t' ,t, S 7.` <br /> 5ignature �� c � Registered Y/ N Fee Current Y/ N <br /> Address (7(,V Q �p h/j � - (� D"�icense # <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 <br /> License # <br /> MECHANICAL Company <br /> Signature Registe2d 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 /> Dir � . — , <br /> ections: �' <br /> Fiil out application completely <br /> Owner & Contrector sign back of application, notarized (Or, copy of signed contrect with owner) <br /> If over $25��, 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 />