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a�s-�ao-oo2o City of Zephyrhills Fire x-a4a-�so-oo2� <br /> Permit Application -'�� ��'� <br /> Date Received ���� l o�� Sr . �Phone Contact for Permit �y� / �f <br /> --- -------�,<.,_- --- -- -,. ,_ .. _.. _ <br /> . -� <br /> r___�.._ _.__.._,.._ __.____....—_°---:-- ,._.. _ _____�__._�.---,-- -- .�- - -- __.d___.r.._� <br /> - -_. .Y.—=` --_.�___.. .._ _..v..:... ,- --- _-a.... <br /> Owner's Name f Zs �/�C'� I` Owners Phone Number` � 3 � � [� <br /> Owners Address Q � �' ` � I � �/ � <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address � <br /> __ ___-_ _�_._._-�.>= --- -- - - .-- - - _..:IT�--- — -- - - _ - : - �._--.._ �° - - <br /> Job Address -._% �Ur /.� �f__`;_../���. ...,��;- - ----�� - --�--��--�`� -- - - 4Lot# _..� <br /> �p � / / <br /> Sub Division Parcel# <br /> � �_--- -�_--- - -°---__,.--...�. :_--_r <br /> -- -. _ _ <br /> _____._- _..___.__ _ a«._.._� - - - ---- -- -- -- -- - - - - - - - -• - - <br /> t_-- _-. - __.�:____-- -__�_�..�. ________r_� s_ . �__ -�.�. _ .__ __:-__.-.�___ . ---- --�.___..___ ..Y- ---- -:= <br /> Bio-H rd-Niaste°Storeg NUAL � Fumigation Tent <br /> �Comm Exh �st Kitchen Hood/Duc � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> Con ro led Bum � 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 /> ' t y emi �n t er � ` <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum � �� <br /> Fire Alarm ❑ ❑ ❑ � ' <br /> � � � Sparklers � ,�r�- <br /> Hood Cleaning � ❑ ❑ ❑ � � y Q Sp Q �� � (� <br /> I Sprinkler S stem Installations <br /> ( �C <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> ��l �\f1�" <br /> � Fire Alarm installation � Torch Roofing/Tar Kettle � <br /> � Fire Pumps � Waste Tire Storage ANNUAL «� <br /> � FlammableApplication-ANNUAL Valuation of Project <br /> � � Fuel Tanks <br /> Q Other: tJ � �>•� J i O � e <br /> t_ �:_�_....,_�_.�.J...-.----m_.-�_ - ...��__.:.�..w-- -°__��_�,_.°_..��_.��s�;_..__.�-�.�_w_,..---�---_.__.__.�._�.-._:-�_______...._.._.�___..__�..�.�.=;..�_._ ._�:� <br /> Contractor Company j � 4 � ysts �'/[ ,1�YJ[ <br /> Signature Registered Y/N Fee Current Y/N <br /> Address l� 7� C7/.,.�(t o/}� pav S /fcQg License# - � � � �j <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 /> � <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address � License# <br /> r - - -- - - - <br /> ....____ _..._�.,.____ . . - _ - -- - <br /> -- �._..� :__._4. ._. ._. . .-�----- _�_.....�T, �-__�......�.___ _. ... .,_,._:.- .. . , <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 Tax Notice(http://appraiser.pascogov.com) <br />