Laserfiche WebLink
s�saso-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit 7 a J s a �ro <br /> Owner's Name � }l f� (�U1(1r1 f1 � Owner's Phone Number a � � � �6 <br /> Owner's Address 3�a� Q � �rn ��" ��� <br /> Fee Simple Titleholder Name Titleholder Phone Number C� � �� <br /> Fee Simple Titleholder Address <br /> Job Address �p�d v 4-�� �JI ° � r�� � � Lot# � <br /> Sub Division Parcel# 3s'as"�( '"��D� �7�—��� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> aControlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL <br /> �y emi �n er � (_�� <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum V�I ��� <br /> Fire Alarm � ❑ ❑ � � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ � � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation a Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other <br /> Contractor Company %� �'e�.fi � S �m <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# p S <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 /> MECHANICAL 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 /> Directions: <br /> Fill out application completely <br /> Owner&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 applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tau Notice(http://appraiser.pascogov.com) <br />