Laserfiche WebLink
a�saao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Appliqtion <br /> 3te Received � Phone Corrtact for Pertnit �� 3 a 1� <br /> wner's Name ` Q l /� �� Owner's Phone Number �� 7 � 3�'� <br /> wners Address ��y� � , Z� �J/' /j/ ��S 3 �2 <br /> �e Simple Titleholder Name Titleholder Phone Number � C� C� <br /> 3e Simple TitleholderAddress <br /> �b Address �y t 1� � )v (s� � Vl� I S ?j 3 J�Z Lot# � <br /> �b Division Paroel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> a Comm Exhaust Kitchen Hood/Duct � Hood Installation <br /> � Cantrolled Bum � LPMatural Gaslnstallation <br /> � Emergency Generator<30 kw � lPMatural Gas-ANNUAL Sale <br /> aEmergency Generator>30 kw � Places of Assembty-ANNUAL <br /> � Fire Protection Maintenance-ANNUAL � Recreational Bum ^ <br /> �IY m� � er �� <br /> .' `./ / <br /> �p�{„�(C�prinkler � ❑ ❑ ❑ � Sparklers � I <br /> U.all.l.�C <br /> 3� f� Fire Alartn � ❑ ❑ ❑ � � Sprinkler System Installations � � <br /> m 1 �� Hood Cleaning � ❑ ❑ ❑ � � gqndpipes(Sprinkler Sys) <br /> Hood Suppression � � ❑ ❑ � � Torch Roofingffar Kettle <br /> � Fire Alartn Installation � Waste Ti�Storage ANNUAL <br /> � Fire Pumps <br /> � Fire V1�rks <br /> � Flammable Application-ANNUAL <br /> Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> antractor �p V�� ��V� i `.. <br /> gnature '�`��"� •- �"� ComPany <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />_ECTRICIA 5'�!I -� �it,J � �`-�� Company <br /> gnature ''y Registered Y/N Fee Current Y/N <br /> Address License# <br />_UMBER <br /> Comparry <br /> 9��� Registered Y/N Fee Current Y/N <br /> �d� License# <br /> ECHANICAL <br /> Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> THER �om�rn <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> rections: <br /> Fill out application completely. <br /> Owner&Contractor sign back of appNqtfon,notarized(Or,copy of signed contrad with owner) <br /> If over 52500,a Notice of Commenoement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with appRcable documentation <br /> Allow 10.14 days for rev'iew at�r submittal date. Paroel#-obtained from Prope i Tax Notice(http:!/a praiser.pascogov.com) <br /> �a���� �(Y1Gl,t I� a�� �..5 <br /> ��• � <br /> go.s��rr»��,,�,��e � <br /> P:�l:i�� F:�� <br /> g� <br />