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( a reAl —. <br /> 813-780 -0020 City of Zephyrhills'Fire 1 9 (0°3 Fax- 813- 780 -0021 <br /> Permit Application <br /> Date Received 3 0 ' Phone Contact for Permit l <br /> n ,...{ , tr G � , .+.v <br /> Owner's Name V f 6)2 06 L r3 6-11 I l� C �S7 Owner's Phone Number j52 1 3 7g) Z5O8 <br /> Owner's Address 3 / 7 3 5 C HA Al 1 b/� U I / ` O RJ) <br /> Fee Simple Titleholder Name DA V -C 15 Q 0 li I Titleholder Phone Number g /3 7 s9 / ; s vg <br /> Fee Simple Titleholder Address I 9 / S 1.644 f)2 ) V im — Z i L L-.5- ? ?s i <br /> c.a f,s:jaw.. . a `v.a. „aAke:,.»..a �, n. rmw.mtar ,.s FsG= :a'... - -,, Y>s8. . .ly "et 0,- <�,.�, .r r m Y�.',`xg i!,4y��a .d7'i°¢ g.5... 5isi tl:�r.: .s. :;,�a.aa!uzav,:ati a�' en.x p.. . '. <br /> Job Address ? / 7 .g ckNC' f-D 2_ 1Lt',S r- "33 y,...2- Lot# <br /> Sub Division / Parcel # <br /> . ,. _ '',, ,; ,,,,- ?-= ,. „..., ,,,, r ,. :m .;,. "?E::;r . umni witz u �Z G' gtuinim>.rw ... " 'i+5:..... o-aaa+'. mw.. m z . r.. s`:,m,,,• <br /> Bio- Hazard Waste Storage - ANNUAL I I Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> 1 vl Controlled Bum I I Hood Installation <br /> n Emergency Generator < 30 kw I—I LP /Natural Gas - Installation <br /> h Emergency Generator > 30 kw n LP /Natural Gas - ANNUAL Sale <br /> I ( Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> v.- (tUtrlvl (Semi' I" i- 1 tither <br /> ,,--z n j?J' (11/4- _ Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> OD <br /> ./ 19/1 <br /> lei � �' I n I I I I Sparklers <br /> ler <br /> alp Hood Cleaning ❑ ❑ ❑ n I 1 i <br /> Sprinkler System Installations <br /> / ��y� Hood Suppression n ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> ' n Fire Alarm Installation I I Torch Roofing/Tar Kettle , <br /> 0 d n Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application- ANNUAL 1 ( Valuation of Project <br /> Fuel Tanks <br /> I Other: I I <br /> Contractor Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address 1 1 License # I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address 1 I License # <br /> PLUMBER Company I <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I License # I I <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address 1 1 License # I I <br /> OTHER Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address j License # <br /> I -`!"u".�.'"€`'&cau:'�'.:. <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 />