Laserfiche WebLink
813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> . <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> � �. ... . -_ ... . .. .. . _ .._- , . .. �._� .. -_..� �€ca .:s�. .._. ..��:':����acm e e'""""�.'� � E.�;e,.�.„�� , <br /> Owner's Name � f" — �r's Phone Number �,� � � <br /> Owner's Address ^ 3� <br /> Fee Simple TiUeholder Name �L, Jb� Titleholder Phone Number I'�FI'� 1 I L.�.2. � <br /> �=�—� �s�rs�� <br /> Fee Simple Titleholder Address n <br /> �r�. <br /> Job Address � <br /> Lot# <br /> Sub Division Parcel# <br /> �. � . ,_ ,�.. �: ; � �g�f.�n�pa� �,_ �.������� �� <br /> � Bio-Hazard Waste Storage-ANNUAL � pumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled 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 � Places of Assembly-ANNUAL <br /> trly emi Anl ther ❑ <br /> Sprinkler � ❑ ❑ ❑ Recreational Burn �� � (� <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers ` t <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkier Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar 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 /> � � r _ � �. � � �� °�w' ��a��� �� � <br /> Contractor <br /> � - Company <br /> Signature ( ✓ Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBER I�' <br /> Company � <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL Company <br /> Signature Registered I Y�N I Fee Current Y/N <br /> Address <br /> License# <br /> OTHER � <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> . ... _.. .... . -.�e .�x' -. or :�.�.�'�n ..�:'._%h.«h,. :..��» ,d e =�,.. <br /> Directions: �` �"'� " � <br /> �r; �^9� .,�._:..� a�—�--� _.,H..__ �. .�a^""^*._^„^�,.'� <br /> :n � ��. ����� <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 aker submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />