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• <br /> 4 C /1 4961 / <br /> 813-780-0020 City of.Zephyrhills Fire. Fax- 813780 -0021 <br /> Permit Application <br /> Date Received / O —c 7 . Q D' Phone Contact for Pe <br /> milt <br /> YF- K.?a�v.:ei'l . .exit .. i. v E �.rir. n.+ i. .a:�.+�4x.:.'.a.. +w.v✓..we,.�. .. m. .�r.�..- ....�.,.rn <br /> ... .•Y; ..-tea .a ..w,.ze+ a8tt' <br /> Owners Name TTGIt /fan ae C.C1t2e Owner's Ph / one Number t ( 3 72 7/fL� <br /> Owner's Address �� e 21 1 - _ - 1 ! r -`(�- — <br /> Fee Simple Titleholder Name //C2 AirryfZ C4VL, Tit -holder Phone Number <br /> Fee Simple Titleholder Address Kfil.kT�M /r[ r�r��(]7 M`�a <br /> re arz ��' tw ., - , . .,, ,. ,.w_ ,» Y v _ ,; . _, ..u, " iM"Y". ."..,t4. 4. z+.4s ,MO" .1 FISM it C a: ; .., yr:; >, S.. • <br /> Job Address : L - a i L I ( . / Fi___ 336 f2ot # <br /> Sub Division Parcel # <br /> I Bio- Hazard Waste Storage — ANNUAL 1 I Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL I Places of Assembly- ANNUAL /2 3 /07 <br /> It.ttnyI 1bemil Other <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I 1 1 Sparklers <br /> Hood Cleaning n )2 ❑ ❑ 1 1 n Sprinkler System Installations U <br /> c. <br /> Hood Suppression n ❑ ❑ ❑ 1 I I I Standpipes (Sprinkler Sys) V� / <br /> I Fire Alarm Installation n Torch Roofing/Tar Kettle . <br /> Fire Pumps I Waste Tire Storage ANNUAL <br /> H Fire Works <br /> Flammable Application- ANNUAL I ( Valuation of Project <br /> Fuel Tanks <br /> FT Other: I <br /> o- 3 .'1a ., ":a+ a.,..m4 -sU r r _ -Y .. ,_• - ne..7, aN'b.:. ,Y.rA„s <d�3' ..rs:;� ':®� ..:eWi.K.}r,.,+znee... �,. t, <br /> Contractor M ' — ® Reg s ,� Si ig natuature Re istere ered Y / N Fee Current Y / N <br /> Address I I License # <br /> • ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I License* <br /> PLUMBER Company <br /> Signature Registered Y / N 1 Fee Current I Y / N <br /> Address I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current Y / N <br /> Address I I License # <br /> OTHER . Company <br /> Signature Registered Y/ N 1 Fee Current 1 Y / N <br /> Address 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 $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 />