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1313 -730 -04320 City of.Zephyrhills"Fire - 0 gti6(0 Fax- 813- 780 -0021 <br /> Permit Application <br /> Date Received ontactf <br /> Phone C or P <br /> Owners Name IVOvA e-e-4/WAVC Cr , /N/• Owners Phone Number <br /> Owner's Address #4= 0 L. t?OX 4/966 'TAm'.4 / </- 336 97 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> „ " t. .0. 7. ,,,,,47. V.711 .r W. s ra..-. ,,., . .4 :,, - • . =a '2 3 F;a.? . :1z -,=. ,sr = „x , ':'1',.'; 'v" v. 'suer lke,..Ar. sslt- . <br /> Job Address !�, Ci A y:04//1 Gi e5 Ci' • 6 4 ai ti i Lot# <br /> Sub Division Parcel # <br /> P iG'' Y':F,$ G✓?5S * u*C£; _a?r :j w.edKX+k**' .�.*.4*bt ,i.. - -> ....=..r ,.w- �coe ,.�r,n f.._3_e >�....:.;w. <i*`,r i.; ..?tS” +'a;tib.�.l2i . �P�u v..u.. 1 -- �h'xih'�' 4 :+'ld".m"'.'.3 =Y r&.* . <br /> n Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> I Emergency Generator < 30 kw - n LP /Natural Gas - Installation <br /> Emergency Generator > 30 kw 1 1 LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> IUtny1 'semi' JAni 1 tither <br /> Sprinkler n ❑ ❑ ❑ ( ( Recreational Bum <br /> Fire Alarm I ❑ ❑ ❑ I Sparklers <br /> Hood Cleaning E III ❑ ❑ I I I 1 Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ ( ( n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> I I Flammable Application- ANNUAL I ) Valuation of Project <br /> I I Fuel Tanks <br /> In Other: I <br /> , kP as d'a'+t -:,<�, . ... . Ys✓nrn ..�.u.. -., t �,,. --. -g, .. a .oaE ,. ....z .a W�:=L;Miritt ';wr —rn a.�.. .. _s,u tea. .a. -s„ .,, s.era*✓s:. <br /> Contractor Company /NOVA eG.EAA IVG' jeoe, /NC. I <br /> Signature 9. .8 /LG oc Registered Y / N I Fee Current I Y / N I <br /> Address I P.O. SOX •460 77.402A. 33677 I License# <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # I I <br /> PLUMBER Company I <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I 1 License # ( I <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current 1 Y/ N 1 <br /> Address I I License # I <br /> OTHER Company I <br /> Signature Registered Y / N J Fee Current I Y / N J <br /> Address I License # <br /> n,, �.. --�.. - . ... <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 />