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<br />City ofZephyrhills Fire <br />. Permit Application <br />Phone Contactfor.Permlt 9'~ 9- <br /> <br />Owner's Phone Number I ~ J.J 1171r C2.. Iw ~I )' <br /> <br />. ~C> tlo .-7/$"1 <br /> <br />. I Titleholder Phone Number III II <br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br /> <br />ner's Name <br /> <br />OWner's Address <br /> <br />Job Address <br /> <br />I <br />I <br />i tt7N bair)' RJ <br /> <br />Fee .Slmple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />1 4'Q ~ <br /> <br />Fax-813-780-0021 <br /> <br />Sub Division <br /> <br />Parcel # <br /> <br />I <br /> <br />] Lot# I <br /> <br /> <br />l"'" "'NtU .KUM "K"""K" ,"^ NU """J <br /> <br />o Bio-Hazard Waste Storage - ANNUAL <br />.D Comm Exhaust Kitchen HoodlDuct <br />D Controlled Bum <br />D . Emergency Generator < 30 kw <br />o Emergency Generator> 30 kw <br />~ Fire Protection Maintenance ~ <br />Sprinkler 0-===:-. <br />. Fire Alarm . ~ <br />Hood OeanlSuppression 0 <br /> <br />D Fire Alarm Installation <br />D Fire Pumps <br />. D Fire Works <br />D Flammable Application- ANNUAL <br />D Fuel Tanks <br />D Other: I <br /> <br />:~:atuc;:r I ~ ~'. <br /> <br />Add~ is-if'?! w. w..re.f5 AY~ 7'Ji"'j>'I, <br />ELECTRICIAN <br />Signature <br />Address I <br /> <br />I <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />StandpipeS (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />., <br /> <br />Valuation of Project <br /> <br />I <br />~'l <br />I <br />I <br />I <br /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />[dDT [jecUriry .seT'Vlce.5 <br />L Y ~_ Fee Current I · Y 1 N-t <br />e-r C?t?t:!J//o..:3 I <br /> <br />Y IN I Fee Current I Y I N I <br />I <br /> <br />Y I N I Fee Current I Y I N I <br />I <br /> <br />Y/N I Fee Current I Y/N I <br />I <br /> <br />Y/N I Fee Current I Y/N I <br />I <br /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />Company <br />Reglst~red <br /> <br />Ucense # <br /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />.- <br />