Laserfiche WebLink
813-780-0020 City of Zephyrhills Fire Fax-a�saao-ooz� <br /> • Permit Application <br /> Date Received Phone Contact for Permit � � �� <br /> Owners Name �/�� Owner's Phone Number l�y 0 � <br /> Owner's Address 4�`�-� �•��!-��j1�j���{ ,�...,aQ�,�� , r 'z�'C/� <br /> Fee Simple Titleholder Name � � Titleholder Phone Number �� Q�3 <br /> �L.J <br /> Fee Simple Titleholder Address <br /> ; . ,s� ,_ <br /> _ . . ,:'";§!� �°s'�,���'.,�-�"a��:�" <br /> �. .<��Y.�. ��_� ;�t,--.�''sn. .�_� ?.a:.;� .. ;iA��4-:_.l'�'`d>. �.�k�: <br /> JobAddress �� � � �1 ��� ��� Lot# � � <br /> Sub Division Parcel# <br /> „ ' �-�, ..s�=r� :n�:.<.�..;� .� ': ."*�..�-'-'=3"'�+�..:;;�"k�b :*.";:. .. '�£�..t ,:�'� '._,.;",3'. . :3�?�"'� ...'�.��a^1,�a. .:��z;: . ,�_ .�.��' �i=.:� .. .�;� '�"�`ti�= .:��.�wx.e; <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent � <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier 11 or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale <br /> � Fira Protec4ion Maintenance-ANNUAL Places of Assembly-ANNUAL �� <br /> ry emi �n t er � 1 / - �/'` <br /> Sprinkler � ❑ ❑ ❑ B � Recreational Bum /� ( v <br /> Fire Alarm ❑ � O � � Sparklers <br /> Hood Cleaning ❑ � ❑ � � Sprinkler System Installations <br /> Hood Suppression ❑ ❑ O � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Instaliation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Appiication-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> � Other: <br /> � ., .� . _ �.,�„ <br /> , �� ��4..���� �.�_� ,. ,�� ���-: _� �� .. �.v�:�- _ ;�� �,�. . <br /> / � _ �:. �� -�� .�.. -,�� <br /> .. , <br /> Contractbr ` <br /> , Company <br /> Signature`,\ ` Registered Y N Fee Current Y/N <br /> Address <br /> License# <br /> ELECTRICIAN <br /> Company <br /> Signature Registered Y/N Fee Curcent 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 <br /> License# <br /> OTHER <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> � , : _� � � . .._.,. <br /> _�, _ , ., <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 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 applicabie documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />