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a��-�So-oa2o Cify af Zephyrhills Fire Fa�c-813-780-4021
<br /> Permit Application
<br /> Date Received �— � Phone Contact for Perm t �
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<br /> Owners iVame ,� �y�} Q� �' Owne�s Phone Number
<br /> Owner's Address ,>( S6 s � �a l� 1U'
<br /> Fee Simple Titleholder Name Titleholder Phone Number � � ��
<br /> Fee Simpie Tif{eholder Address
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<br /> Jab Address Lot# ��
<br /> Sub Division Paroel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL �'' Fumigatian Tent
<br /> � Comm E�chaust Kitchen HoodlDuct Q Hazardous Material{Tier 11 or!2Q Facility}AtaHUAI
<br /> � Controlled Bum � Mood Installation
<br /> ` � Emergency Generator<3Q ktnr � �P1Natural Gas-Instaltation
<br /> � Emergency Generatnr>30 kw LP/Natural Gas-ANNUAL Sale
<br /> � Fire Frotection MainYenance-ANNllAL Places of Asserrib(y-ANNUAL
<br /> � t�r y' emi ALT�n er �
<br /> SprinWer O GI ❑ Recreatianai Sum
<br /> Fire Alartn � ❑ ❑ ❑ � � 5parklers
<br /> Ftood Gieaning � p C} O �� � Sprfnkter System Insfalfations
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alsrm Ins#allatian � Torch RaofinglTar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> Flammable Application-ANNI3AL !��
<br /> Valuation of Project
<br /> � Fuel Tanks ������
<br /> Q Oth6C.
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<br /> _G`o,1ntractor .t--� � Company
<br /> �gnature 1�"� �
<br /> /�,,, Registered Y/N, Fee Current Y/N
<br /> Address License# �
<br /> ELECTRICIAN Campany
<br /> Signature Registered Y 1 N Fee Current � Y J Itj
<br /> Address License# ,
<br /> P�UMB�F2 Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address Cicense#
<br /> MECHANICAL Campany
<br /> Signature Registered Y 1�) Fee Current Y 1 N
<br /> Address License#
<br /> OTHER �
<br /> Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
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<br /> Fiil out application camplefely.
<br /> Owner&Cantractor sign back of application,notarized(Or,capy of signed contract with owner)
<br /> !f over$2500,a NoUce of Commencernen2 is required{Mechanicai work over$5p00}
<br /> Supply two(2}sets of drawings with applicable documentation
<br /> Allaw 10-14 days for review after submittal date. Parcel#-obtained from Properly Tax Notice(http://appraiser.pascagov.com)
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