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aTs-7so-oo2o City of Zephyrhills Fire Fax-$13-780-0021 <br /> " � Permit Application <br /> ,r-� !� I <br /> Date Received C��-��(J � Phone Gontact for Permit � _ 2. -L _ �� j b <br /> .. � «.�... ._..._. .a,... - a <br /> Owner's Name �-�� �R�� Owners Phone Number ��3 8�� ��� <br /> Qwner's Address ! !�� l��L�^` ��--�D <br /> Fee Simpie Titleholder Name Titleholder Phone Number C� � � <br /> Fee Simple Titiehotder Rddress <br /> �`�""'.""_.___�.m._�__ _ <br /> Job Address ���� �t`�L-c_ L 11 V � Lat# �� <br /> Sub Division Parcel# �5"2,� '�,I - ��3 a--o�cao o�-O�(,��y <br /> �. _....�..�. - ,m - ....�.. ..._,_ „ ,.�'_____'^"�'--� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Maferiai{Tier ti ar RQ Facitity}ARlNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<g0 kw Q IP/Natural Gas-Instaiiation <br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale <br /> � Fire Protectio�tViaintenance-ANNUAL � Places of Assembty-ANNUAL <br /> r y emi �-nf er <br /> Sprinkier � ❑ ❑ ❑ � Recreationai Burn <br /> Fire Alarm � ❑ _ ❑ ❑ � � Sparklers �/�,��7� <br /> Hood Glear�ing � ❑ ❑ ❑ � � Sp�inkler System tnstatlations � `y <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> �_ Fire Aiarm tnstallation ��e'y L�.c1�,"{Z� Q�''s'�I..�� � Tarch Roofi�gtTar Kettle <br /> C,� <br /> o Fire Pumps � Waste Tire Storage ANNUAL <br /> � �;�������� '7p�����,t}�j� Valuatian of Project <br /> Flammable Application-ANNUA� r �( <br /> � Fuei Tanks <br /> Q t7ther: <br /> ��— ,......____. � - ..._.,.�...d e....,��_� �..._.__�______.w._...__ .__.._�–�,:.�.--� <br /> Cantractor " Company �`?Q�1.. PPs�'�`��[�o..� S�j$��t�S <br /> Signature Registered Y/N Fee Current Y/N <br /> Address "� (1G�lt�� !'�-�' �r�f'�lt;/L ` Lvl� �icerrse# �r'2��'a j12Z <br /> ELECTRICIAN Company <br /> Signature � Registered Y I N Fes Current Y 1�1 <br /> Address License# <br /> PLUMBER Company <br /> Signature Regis#ered Y/N Fee Current Y/N <br /> Address �icense# <br /> MECHANICAL Company <br /> Signafure Regisfered Y 1 N Fee Gurrent Y 1 N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> �._�-�`�' _...� ..___...� .... - _L._.. -� <br /> Directions: <br /> Fili out appiica6on complefeiy <br /> Clwner&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$5600) <br /> Suppty two{2}sets of drawings with applicabie dacumentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained fram Property Tax Notice(http://appraiser.pascogov com) <br /> � <br />