11-12499 - Laserfiche WebLink

Browse Search

sis-�so-oo2o City of Zephyrhills Fire Fax-813-780-0021 . Permit Application Date Received y /� / 26%/ Phone Contact for Permit �1 �l �i �Q Q' 7,�,�' Owner's Name �G I�' i'1 /�-G.J � JL.'�jp(7�- Owner's Phone Number �� Owner's Address � � 3S �� : �C � � � �[ J 3 � 7' z Fee Simple Titleholder Name Titleholder Phone Number �� Fee Simple Titleholder Address Job Address Lot # � Sub Division Parcel # � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Faality) ANNUAL � Controlled Burn � Hood Installation � Emergency Generator < 30 kw � LP/Natural Gas-Installation � Emergency Generator � 30 kw � LP/Natural Gas-ANNUAL Sale � r c � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL / 2 7� r y e m i � n t e r � Sprinkler � ❑ ❑ ❑ B � Recreational Burn Fire Alarm � ❑ ❑ � � � Sparklers Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations Hood Suppression � ❑ ❑ ❑ � � Standpipes (Spnnkler Sys) � Fire Alarm Installation � Torch Roofing/Tar Kettle � Fire Pumps � Waste Tire Storage ANNUAL � Fire Works � Flammable Application- ANNUAL Valuation of Project � Fuel Tanks Q Other Contractor Company �dt /Z� Signature Registered Y/ N Fee Current Y/ N Address License # ELECTRICIAN Company Signature Registered Y/ N Fee Curcent Y/ N Address License # PLUMBER Company Signature Registered Y/ N Fee Current Y/ N Address License # MECHANICAL Company Signature Registered Y/ N Fee Current Y/ N Address License # OTHER Company Signature Registered Y/ N Fee Current Y/ N Address License # Directions: Fill out application completely Owner & Contractor sign back of application, notanzed (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov com)