Laserfiche WebLink
s� �-�ao-oo2o City of Zephyrhills'Fire� <br /> Fax-813-780-0021 <br /> Perrnit Application • <br /> )ate Received = <br /> :�s+v�e_:;;¢c��;�-,,,,,, - Phona Contact for Pertnit <br /> hvne�s Nama � �� ~ <br /> e � CJ Owner's Phone Num6er y �� N � } <br /> 5 �� �1�] J' <br /> )wner's Addrass S 3 3 �e s !.3.35 �. <br /> ?ee Simpie TiUeholder Name TiHeholder Pfione Number C� �� <br /> -ee SimpleTitleholderAddress <br /> n. <br /> Job Addr=ss ,3 S � ,��-_��� <br /> 2� � t S � s�. �ot # � <br /> 5ub Di�ision � � � � Parcel # � . J � Q,r`/v ,. �C �d0 <br /> - dO 7!� <br /> � ���� :�:,�.r�.�:,��: <br /> Sio-Hazard Waste 5torage - ANNI! L � Fumigatlon Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazarclous Material (Tler I� or RQ Facllity} ANNUAL <br /> � ConVolled Bum a Hood Installatlon <br /> � Emergency Generator < 30 �r � LP/Naturel Gas-Installation <br /> Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Proteation Mairrtenance -ANNUAL � places of Assembly-ANNUAL <br /> � � y emi nT er � <br /> Sprinkler O ❑ p Recreadonal Bum ���5 <br /> Fre Wartn � � � <br /> �� � SparWers � <br /> Hood Cleaning � ❑ p ❑ S rinkler <br /> ❑ � o P System Installatlons <br /> Hood Suppresslon ❑ ❑ O Standpipes (Sprinkler Sys) <br /> Q Fire Alarm Installation � Torcfi. Roofingf!"ar Kettle <br /> Fire Pumps o Waste lire 5torage ANNUAL <br /> Fire Works • <br /> Fiammable Applicatlon- ANNUAL ^---� <br /> Fue( Tanks � I Valuation of Project <br /> [� Other; <br /> Contraotor � � �\ m�,��_e,.n. <br /> Signature Y \ . Comparry << �` ,� � L. <br /> `.J � Yl <br /> Registerecl Y N Fee Current nj <br /> Address � � <br /> � License # � �y i � <br /> ELECTRICIAN <br /> Signature Company <br /> Reg(stered Y/ N Fee Current Y/ N <br /> Address <br /> Licanse # � <br /> PLUMBER <br /> Signature Company <br /> Address <br /> Registered Y/ N Fee Current Y/ N <br /> Ucense # <br /> MECHANICAL <br /> Signature Company — <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> OTHER License # —"-� <br /> Signature Company <br /> Address <br /> Regiatered � 1f / IV � Fee Current �' / N <br /> ���'� _ Lioense # <br /> D aechons: `""`'�==-� =.�'-�-�...d.W°-° -- <br /> Fill out appUcation completely. x '"'" ''` � �� <br /> Owner & Contractor sign back of applica6or�, nota�ized (Or, copy of signed contract with owner) <br /> If over $250D, a Noti�e of Commencement fs required (Mechanica! work over 35000) <br /> Supply two (2) sets of drayvings uvith apPficab�e documentation � <br /> Allow 10-14 days for review aiter submittal date. Parcet #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />