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013-780-00,20 �' City of Zephyrhills Fire Fart-e13ae0-4421 <br /> r Pefrinit Appilcation <br /> Date Received Lk� Phone Contact for Permit 113 __i <br /> Owner's Name �AS Ol.SGO. 1S .0 ht�l n Owner"s7Phone.Number <br /> Owner's Address lle. Z yti t S L.- •.J c3� <br /> Fee Simple Titleholder Name Tittetiotder Phone Number . <br /> Fee Simple T.,Itleholder Address '- i t` /� <br /> Job Address 3 0 ©$ ~v�� ("{�►t I I S' [� 3 l�� 4: } Lot# <br /> Sub Division, <br /> Parcel# 'octaa"',2�.. Q�'j(� :.. . . . <br /> Bic--Hazard"Waste Stdraoe.ANNUAL Fu nioattoh Tent <br /> Q Comrii ExhiustKt- h-an Hood/Duct Hazar taus Material(Tsar II or RQ Facility)ANNUAL <br /> Controlled Bum Hood Installation <br /> Q Emergency Generator a 30 kw LP/Natural Gas-Installatior <br /> Emergency Generator>34 kw LPiNaturaFGas=ANNUAL Sale t <br /> Q Fire Protection Maintenance;.ANNUAL Q Places of Assembly-ANNUAL <br /> Sprinkler ,, ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm El ❑ ❑. ❑ E:1 Spariders 4 <br /> Hood Cleaning ❑ ❑ ❑ Sprinider System installa <br /> Hood,Suppression M ❑ ❑ El r Standpipes(Sprinkl S ) f <br /> Q ,FireAlarm Installation M Torch RbofingITa *ray <br /> . Fire Pumps Waste'Cire Stara a ANN <br /> RFlammable Application-ANNUAL. (a Valuation Of Project <br /> Fuet Tanks <br /> � atiiei: - <br /> Contractor Company <br /> Signature Registered Y'/N Fee Current <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y IN Fee Current <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered ' Y J N Fee Current YIN <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y 1 N <br /> Address License# <br /> OTHER ,�/j � Company (t i- ro e <br /> Signature .J��"vim- Registered:+ Y JN Fee Curriant Y"J N <br /> Address 2 h rGt'+ License# <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$50001, <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tare Notice(hftp://appraiser.pasoDgov.00m) <br />