Laserfiche WebLink
a�3-�ao-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received cr Z _ Phone Contact for Permit f � Q j 3 7 <br /> nvner's Name 7, Owners Phone Number <br /> tivner's Address � G�{� �(/ <br /> ee Simple Titleholder Name Titleholder Phone Number � � � <br /> ee Simple Titleholder Address <br /> � �° - _ a� - - ,�_ _- "` ;�s°'a"` - - ' <br /> �b Address Z� C./J �Q L.L �l V � <br /> Lot# <br /> ub Divi:.;:sn Parcel# <br /> _ _ - . .._ . ., . _ _a �xa r=-r,:Nv,r.m.•e-:, „ �.?-_ ,.,-.. .: ,. -. _ - , - _ . ,'.. . ..1:..la�:4.ai... ?C'�XA.'w 37r8.Yt' .. _ k. � .-� ... <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Controlled Bum � Hood Installation .!� <br /> � C�<< <br /> Emergency Generator<30 kw � LP/Natural Gas-Installation y{-�f � <br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale �f' � <br /> 0 (�, <br /> Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ B � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ O ❑ � Sprinkler System Instaflations � � �"I � ��l�s <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) � �J ��� 'S�e� <br /> � � IY /S; <br /> Fire Alarm Installation Torch Roofing/Tar Kettle V <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br />"_ _ _ _ � _ L ,.-. _ _. � a!n���n `_ � -. ��. 'E3'y'N'"t:'R- '-( ," . i t.-, � <br /> - � - - ..., _ ,-- -.Y.sa�. ti.1'f`"i.'!'T^4F,. �.1 <br /> ontractor Compa�y � �,/�/•C M1.�D ` <br /> ignature � D �Q�l?[.t, Registered Y/N Fee Current ` Y/N <br /> Address Z �(a / <br /> License# <br /> LECTRICIAN <br /> Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> LUMBER �, • Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> IECHANICAL Company • <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> THER Company <br /> ignature Registered Y/IV Fee Current Y/N <br /> Address License# <br /> irections: <br /> Fill out application compietely <br /> Owner 8 Contractor sign back of appiication,nota�zed(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 Tax Notice(http://appraiser.pascogov.com) <br />