|
813-780-0020 Cify of Zephyrhills Fire Fax-813-78�
<br /> I �""��`'` Permit Application �i ��L�
<br /> � Date Received — ^-jJT
<br /> ....__.�_a._...,...e,..�_r,�.__ _...�.._.,._.__.. .�,�__.��.�_._ e Gantact for
<br /> �. , �,._.t,_
<br /> .....�.:.-v.,�._.:_�.=.«...__�..�...._:�...r_w�....„�_�_....v...--�..w._.._._,.,..,..._rn..._...,_._.,. ,,.._��.....,.,.�_. __.���_=__e__:._�_....___._ra..:.....,._�i._._..�_.<_�_._.....,..�..,�.,.,.,..,ti._... _r�_<..._..u.
<br /> Phon Permit �t'�
<br /> Owne�s Name �!C� C �C3 Et,RJ�� �t�e Owners Phane Number.� C7� . , .- `7� _ N �itX'.7�
<br /> Owners Address ,. Q�.7 � � � �� �
<br /> Fee Simple Titlehalder Name Tikleholder Phone Number �� C� ��
<br /> Fee Simple Titlehol@er Address
<br /> -�------:.�;.__.__..__.�.,._,w_,-m„,r,�.:s-r--__m.� _
<br /> ,.___w A�...�_..__.�___ _ ,--� „�--,_----°-�--�-�- - -
<br /> --�.f, �. �.�,.,..__,:,-a_,.��.n.� .,-.-�-_--
<br /> �v,....��..__..,:.�.- ;.._�.__y_.�...:� .a..,
<br /> _.�s�..�_
<br /> .�.:_. _.._ �:._. ..,�.,a._,.�.: _.�W.�..,.�_.._::,�.._�,.__.�,w_. ..., �.-.,�-- _
<br /> .w:.,.� _,-i.�.-�._n..,,.eM..,.�.e.�
<br /> -� . ���.,,..,... w3
<br /> Jpb Address ��
<br /> Lot#
<br /> Sub Divisian Parcel#
<br /> ,..w__�,�,z.,,...,_..,.� ,:r-- �-.-w--,�-.,_.,��:,.......,�.,-���....�_�
<br /> a-..f.,_..��_,._._<...� . � __�,_� - - - - -
<br /> �..._.__,___�_.__._�.u.�__».,_„_._...�_,_...��_.�.,._.M. .._�_�.___. ,.�_. ,.:, ..__�_,v�._°-__, __�.�..�.,.�,�>,...._�_.__....�..�:+-w. _.-----._,�:._�_..... :.�,._.._ �__ •_:..s_.F�
<br /> � Bia-Hazard Waste 8torage-ANNUAI. � Fumigation Tent
<br /> Gamm Exhaust fCitchen HoodlDuct � Nazardous Mateeial(Tier i{or RQ Facitity}APINUA�
<br /> /� �
<br /> Controlled Burn Hood Installation
<br /> � Emergency�enerator<3p� o �PlNatural�as-Installatiort
<br /> � Emergency C�enerator>30 kw o LP/Natural Gas-ANNUAL Sale
<br /> QFire Protec#ion Maintenance-ANNUAL � Places of Assembly-ANNUAL
<br /> ❑ t y emi � t er ❑
<br /> Sgrinkier CI ❑ ❑ Recreational Bum � t��2 q
<br /> Fire Alarm � ❑ ❑ ❑ � � $parklers
<br /> Haod Cleaning � ❑ ❑ ❑ � � gpR�kler System Irtstallatians i
<br /> Hoad Suppression � � ❑ ❑ � � Standpipes{Sprinkler Sys)
<br /> � Fire Aiarm insta(tation � Tarch RoafingiTar Keftle
<br /> � Ffre Pumps � Waste Tire Storage ANNUAL
<br /> � FlammableApplication-ANNUAL �i�� Valuation of Project
<br /> Fuel Tanks
<br /> Q Qther: i,o wc?�r 1��r c`�2
<br /> r.:.��_.:-.,�..�_,� _ _ .._�..._� <:�_.._.�._ .��..g e.�-_°t..�w��__U.w.,. _._.a,�._ m..�_...�.__..�.0 -- W------�=:..�-.�°
<br /> �r`OtltCdCtpJ' .�� � �,.,............:-�'» _v.,..-':.-�:,_..__ -...".;','�.,,.. H..,.._.,,."'.,`�±:eu 'E'"a
<br /> Gompany yy��njZj��� � �
<br /> Signature �'t'� • Registered Y/N Fee Current Y/N
<br /> Address � � ��� � � � � �icense#
<br /> ELECTRICIAN Cqmpany
<br /> Signature Registered Y/11E Fee Current Y/N
<br /> Address License#
<br /> PLUMBER Campany
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> MECHANICAL Campany
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> OTHEi2
<br /> Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address Lice�se#
<br /> ,__�._.��._„,��
<br /> �..,..�._.__�::-0.__ - _ ,
<br /> .., _�:�-�..w_.�...,�-....._„..;�:__-�..�.,.�:�_.: �-_�x.:...�._r,...:. _ ,.
<br /> Directions: __.,. __.we_..�„�....._.,._._�__._._.._..�.__,:'K_-_e�_,..._A� ._,.._____ _._._W.:..<.w..._.._..,�..�_y���:__,....���t--._��_�
<br /> Fi(I out applioation completeiy.
<br /> Owner 8 Cantractor sign back of application,notarized(Or,copy of signed contract with owner)
<br /> If over$2500,a Notice of CommeRCement is required(Mechanica(worlc aver$5000)
<br /> Supply twea(2)sets of drawings with applicab(e documentation
<br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:!/appraiser.pascagov.com)
<br />
|