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- - -• — -, • 4 ,. ct.t itt tut I1,LJ DUI LL 1'NU 1A NC, a j _ <br /> �1. lUU - J 21 P. 001 _ <br /> - - 893 - 780.0020 <br /> City ofZephyrhills Fire <br /> PermR •Application Fax- 813-7so -0021 <br /> . <br /> bate Received <br /> p e tact <br /> hon Con <br /> for Permit � <br /> Owner's Name 4-1 �R: E,,.41.1 4 _ . ... • , , :.. _ . 1111.1111 ME <br /> ac zSP•4+y>R al. • <br /> OwtYerrs phone Number .� gin Owners Address 3 g 2,'ZO ' H `CfJ L � . <br /> ` 1 b2 � .P k r <br /> Fee Simple Titleholder Name. <br /> Fee St Address Titleholder. phone Nurgb <br /> Simple l]Ueholder pr • = 111= .1=1 <br /> Job Address S -6(4%\ " t " A g D .J <br /> f L <br /> Sub Division • Lot# <br /> • <br /> 0 BIo- Hazard Waate Storage - ANNUAL • parcel # <br /> Comm Exhaust Kitchen Hood/Duct <br /> Fumigation Tent . <br /> Controlled l3um • Haz ardous Material (Tier II or RQ Faclltty) ANNUAL <br /> " 30 kw <br /> Emergency Generator c Hood Installation <br /> • <br /> Emergency Ganerator> 30 kw ' LP /Natural Gas - Installation <br /> Fire Protection Maintenance ANNUAL <br /> LP/Natural Gas - ANNUAL Sale <br /> • �. <br /> LN r em • Places of gssem(ily- ANNUAL bi C aen 4., <br /> Sprtnkler ®I� JL� <br /> Fire Alarm i 1 0 0 . El Recreational bum 1 1 / 1 O <br /> )0 0 <br /> Hood Cleaning � G 0 1/l 0 , Sparklers <br /> Hood Suppression / Sprinkler System Installations <br /> a 0 0 ❑ .� I Stand <br /> Fire Alarm Installation P pas (Sprinkler Sys) <br /> Fire pumps fl Torch Roofing/Tar Kettle' f <br /> Fire Wpbs .Waste Tfre Storage ANNUAL <br /> ® . Flammable Application- ANNUAL <br /> • <br /> Fuel Tanks Valuation of Project <br /> 0 Other. <br /> Contractor <br /> S • _ E) % / Company _ p ' 'cm 0�- " T. <br /> Address Fr.-_. • Registered rem �"l <br /> • <br /> ��� Fee Current <br /> ELECTRICIAN . - • Liaenee # <br /> Signature I `a 0 4-20 -- (40.1--1-7-1 3 $• Company • <br /> Address Rariatered Y /_________N Fee Current <br /> PLUMBER License # <br /> • Signature company <br /> • <br /> Address Registered ® Fee Current <br /> Y' /N <br /> MECHANICAL License # <br /> Signature Company <br /> • <br /> Address Registered Y / N Fee Current MEM <br /> • <br /> OTHER Lk ekes # <br /> Signature Company <br /> Address Registered MIME Fee Current Y / N <br /> Directlona_ License # <br /> Fill out application completely. <br /> Owner t Contractor sign back of application, notarized <br /> b If over 32600, a Notice of Commencement is r (Cr, copy of worked co3 with owner) <br /> edo Supply two (2) seta of drawls s with a udocumentation <br /> .(Mechanical work over 16 000) <br /> I <br /> Allow 10-14 days for review after submittal a date. l den <br /> Pascal # - obtained from Property Tax Notice (hT(p; / /aplser.peacogov.com <br />