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"" --- -- v.• Lu ,J_ LL.tiit o111 LLJ D131Lll111110 1AA No, LI2 IJU '-IUL P. 001 <br /> i <br /> 813-780-0020 <br /> City ofZephyrhills Fire <br /> Permlt•Applioatio Fax <br /> bate Received <br /> �...m R,_.. . <br /> Pho Conte NMI 1111111 MN <br /> Owner's Name ! O N N %, e M ct for Permit <br /> Owner's Addresg 1p Owner's Phone Number 8 t 3 7 8 2 WM <br /> �OfoO �A Lk-- t3 t--VD ZtiA ve 11 <br /> i L 3 S 4- Z- <br /> Fee Simple Titleholder Name. <br /> Fee Simple Titleholder Address Titleholder. phone Number <br /> Job Address • Q++VN 'fa iA,V' ' *TJD J ci- _ . -• • . , .._. .- .. <br /> SubDlvfslon Lotto <br /> • <br /> ❑ Blo Hazard Waste Storage - ANNUAL • parc4l # <br /> Comm F%traugt Kitchen Hood/Duct ED Fumigation Terri <br /> ❑ Hood Install Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> ❑ Controlled Burn <br /> •n Emergency Generator < 30 kw <br /> LP /Natural Ga on <br /> ❑ D ! mergency Generator 30 kw ' Gas-Instillation Fire Protection Maintenance -ANNUAL LP /Natural Gas - ANNUAL Sale <br /> • <br /> E2 ® • <br /> •, ❑ Places.ofAssemlily- ANNUAL ..:3 3� <br /> Sprinkler <br /> ❑ ❑. 0 • = Recreational Bum <br /> Fire Alarm <br /> ❑ ❑ ❑ ,a = El S • 2 /�o it/ <br /> Hood Cleaning Y ea <br /> I CI <br /> Suppression rms i I V CI L_.J Sprinkler' System Installations j' <br /> 1 0 ❑ ❑ • C❑ ❑ Stara i PeS f / <br /> r )1( 9 9 P ___ <br /> Fire Ate lnstailatlon P (Slxlnkter Sys) <br /> Fire Pampa Torch Roofing/Tar Kettle <br /> Fire Works El .Waste Tire Storage ANNUAL <br /> Flammable Application- ANNUAL <br /> A <br /> El Fuel Tanks . Valuation of Project <br /> Other <br /> Connector , _ .. ,..:.._ .... _. . <br /> _Tito <br /> Signature Company <br /> Address 3 3 1 Registered K//, Fee Current ��/�� <br /> V.1 K ► tT 1-1 ST_ 0 L_ <br /> ELECTRICIAN L 1 icar>ae # <br /> Signature 3 `l (o s Company. <br /> Address Registered Y / N Fee Current <br /> PLUMBER C onipw # <br /> • Company <br /> Signature <br /> Address Registered Y / N Fee Current Y/ N <br /> MECHANICAL License # <br /> Company <br /> Slgnaturr <br /> Address Registered Y / N Fee Current MEll <br /> OTHER License # <br /> Signature Company <br /> Address Registered NZ= Fee Current Y / N <br /> Directions: License # <br /> FiU out application completely, <br /> Owner & Contractor sign back of application. notarized (Or, copy of signed contract with owner) <br /> a over S2S00, a Notice of Commencement is required.(Mechanicai work ever 56000) <br /> Supply two (2) seta of drawings with applicable documentation <br /> Allow 1 014 days for review after submittal date. <br /> Parcel # - obtained from Property Tax Notice (hgp;//apprylser.paacogov.eom) <br /> • <br /> • <br />