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813 - 780 -0020 City of Zephyrhills Fire Fax- 813 - 780 -0021 <br /> Permit Application <br /> Date Received I 1 Phone Contact for Permit 1 I I 1 1 <br /> Owner's Name r I! re- rn fit R is 6 co l._Q t 1......1-e_ Owners Phone Number 14 o Os s 3 1 19u'1 <br /> Owner's Address Zb t 5 S TTrd1/4A` A L pa %L v..t I -0.-06-P 6 (A C i S 2 2 - . <br /> Fee Simple Titleholder Name eRtxSS E-GL. LA') iTi Titleholder Phone Number 4 L S. 9-14(-1 Fee Simple Titleholder Address Imo[ 15 5 _Ind �1S"r44 kt.- -Pc(? �a INt PE R z- 7 5 C% Z <br /> Job Address M5R'tQ 142_2_ LIRA - 61V,a 1 '2,ephkorhiN 1 1 qI 6.564i Lot# <br /> Sub Division Parcel # <br /> El Bio- Hazard Waste Storage - ANNUAL I Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> I Comm Exhaust Kitchen Hood /Duct Hood Installation <br /> I I Controlled Burn LP /Natural. Gas - Installation <br /> I — I Emergency Generator < 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> Emergency Generator > 30 kw I I Places of Assembly - ANNUAL Q <br /> I] Fire Protection Maintenance - ANNUAL I I Recreational Burn n v� <br /> IQtrlyI ISemiI rAnl� Other J _6 •' <br /> Sprinkler • ' ❑ N I I Sparklers <br /> Fire Alarm L ❑ ❑ I I Sprinkler System Installations <br /> Hood Cleaning r 1 ❑ ❑ ❑ I 1 I Standpipes (Sprinkler Sys) <br /> Hood Suppression El ❑ ❑ ❑ I I f I Torch Roofing/Tar Kettle 4 6 7' 2 W <br /> F7 Fire Alarm installation I Waste Tire Storage ANNUAL <br /> I - I Fire Pumps <br /> F - 7 Fire Works <br /> Flammable Application- ANNUAL I Valuation of Project <br /> I 1 Fuel Tanks <br /> I Other Illi ANNUM <br /> I� /_'._i -_f <br /> Contractor , Company t re. M (2it P S C- )lexx.p , Lgt. <br /> Signature ,� �i Registered Y / N I Fee Current I Y / N <br /> Address License # <br /> ELECTRICIAN 1 Company I <br /> Signature ;� 1 y Y / N <br /> Address P- 6 {(1, . 1 <br /> Oft I <br /> PLUMBER ��'��`-' , I <br /> Signature I , l Y / N <br /> Address �`►- ��'p`'/�"A- <br /> MECHANICAL I <br /> Signature 1 7 6 c l- °;`1 <br /> Y / N <br /> Address I !rte v <br /> OTHER %Usjapir I <br /> Signature Y / N <br /> Address ( <br /> D <br /> 4 <br /> irections: <br /> Fill out application completely. Ff 1 -• n _ <br /> Owner & Contractor sign back of application, notarized (Or, copy "C., ) (�� f (�� <br /> If over $2500, a Notice of Commencement is required (Mechanic <br /> Supply two (2) sets of drawings with applicable documentation y Allow 10 -14 days for review after submittal date. ��� )v.com) <br />