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• a13 -Vac 4)020 City ofZephyrhills Fire. <br /> i cation Fax-813-780-0021 <br /> Permit Appl <br /> gate Received Phone Contact for Permit <br /> )wner's Name I \\tow 6 �pw 1 owner's Phone Number IDIMI 1 1 - t 1 I 0SS 1 <br /> )wners Address ( - 1 4 :1 \ 2...k ( \ \ J\Q 7__4 M 'd ;a4 , I <br /> =ee Simple Tkleholder Nurne 1 I Titleholder Phone Number I 11 11 I <br /> Simple Titleholder Address 1 <br /> lob Address 1 I Lot # I I <br /> Sub Division 1 I Parcel It 1 i <br /> VIM <br /> n Bio- Hazard Waste Storage - APRAUAL L �—_ l Fumigation Tent <br /> n Comm Exhaust )Ctcten 1 lioodJDuct 1 Hazardous Material (Tier 11 or RQ Fealty) ANNUAL <br /> ED Controlled Bun El Hood Installation <br /> ED Emergency Generator < 30 kw n LPMatmri rat Gas- Instaltation <br /> ED Emergency Generator> 30 kw n LP/Natural Gas - ANNUAL. Sale <br /> 1 1 Fire Protection Maintenance - ANNUAL ED Places of Assembly-ANNUAL <br /> sprinkler n ❑ ❑ ❑ LJ Reaeational Bum <br /> Are Alarm n ❑ I I y <br /> Sp <br /> Hood Cleaning I ❑ ❑ 1 El Spxmider System Installations <br /> Hood Suppression ❑ ❑ I I 1 1 Standpipes (Sprinkier Sys) <br /> El Fire Alarm Installation El Torch Rooting/Tar Kettle <br /> Fie Pimps = Waste Tee Storage ANNUAL <br /> Are Works ` <br /> Flammable - ANNUAL f Valuation of Project <br /> Fuel Tanks I <br /> 1.11 •� <br /> I <br /> S ignature \ , 1 Y / N F ee Cur rent Y / N <br /> Signature 4111Millellk <br /> ... '"�►�.� <br /> Address n. �.� _ - IL i..._ Jr • License# <br /> ELECTRIC I <br /> Signature I Registered I Y/ N I Fee Current I Y N I <br /> Address 1 ( License* I I <br /> PLUMBER I <br /> Registered YIN 1 Fee Current I Y/ N <br /> Signature Address I 1 License* <br /> MECHANICAL I <br /> Signahre I Registered Y/ N 1 Fee Current 1 Y N I <br /> Address I 1 License it I <br /> OTHER I I <br /> Signature I Registered Y/ N I Fee Cunert I Y/ N <br /> Address i I # I <br /> Fill out application completely_ <br /> Owner & Contractor sign back of applr:otion• notarmed (Or. copy of signed mxxaract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with smokable able doasneikag°n <br /> Allow 10-14 days for review after smmbn itlal data. Parcel* - obtained from Property Tax Notice (M p'.I/app .cam) <br />