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813 - 0020 City of Zephyrhills Fire 4 ( 00 6 1 Fax - 813 - 780 - 0021 <br /> Permit Application <br /> Date Recewe0 Phone Contact for Permit J 7 seY t v i�P1J <br /> .., - ,, -�i,9 xi'E, ,MR9e,�x.�±.. fie.. &:`.�`�g h,E�hlhgm..r i8:r.. ':,;�ys�. 'ae.�fkE'3E'PB�^d.��+.,, �` r. �,.��:��� „�- �:'&�$&:.�rrz��g:n .,.'.`?E3� C=' <br /> Owner's Name I t) JY J\ REA >> ETD l r AL C 1. I N t c i P, Ai Owner's Phone Number 18 13 1 I) 1 S 1 1414141,6 . I <br /> Owner's Address 137160 DA( LG Ro. ZEPHYRN ILLS FL 3�5 l I <br /> Fee Simple Titleholder Name I Titleholder Phone Number I I I <br /> Fee Simple Titleholder Address <br /> ;;'.a'"'�6WrA4,' "' s,M , a, aah.A ° - . , .., �:m. ,. , Mg,.r c+ AM F ^ .A. . s� <br /> Job Address I3770 DA(A. (TA F Rn. ZEPHYRL-1 (I`.L- S a- 3351 / Lot# <br /> Sub Division IC ITY OP ZI_ P4YR 14 1LL S Parcel # I °3 16 OOtO 00/00 <br /> n Bio- Hazard Waste Storage - ANNUAL n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Comm Exhaust Kitchen Hood /Duct n Hood Installation <br /> n Controlled Bum n LP /Natural Gas - Installation <br /> El Emergency Generator < 30 kw El LP /Natural Gas - ANNUAL Sale <br /> n Emergency Generator > 30 kw n Places of Assembly- ANNUAL <br /> n Fire Protection Maintenance - ANNUAL n Recreational Burn <br /> (Qtrtyl ISemil UM Other <br /> Sprinkler ❑ ❑ n Sparklers <br /> Fire Alarm ❑ ❑ El I 1 n Sprinkler System Installations <br /> Hood Cleaning n ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> Hood Suppression El ❑ ❑ ❑ I I n Torch Roofing/Tar Kettle <br /> n Fire Alarm Installation n Waste Tire Storage ANNUAL <br /> n Fire Pumps <br /> n Fire Works <br /> n Flammable Application- ANNUAL I I Valuation of Project <br /> n Fuel Tanks <br /> 0 Ot er I <br /> -. - . -aQ,_Z YLezr . C,''',41".:7 _r U ' uKQ3, . . lINWM k: MINIMIi M NSVV,.,.: Suva ,..26g*N .... rAinIk3 " rs.w. ...'3x'.WV-S , . :,. •AgiV . n: <br /> Contractor i Company RSA P UTW ATIC 5 (kttivKLti S APO PIII4 <br /> Signature ' 'b G- 4..02-L <br /> .I g.-0 r. SAu.er- Registered Y / N Fee Current Y / N <br /> Address - Q,-Z( aTThnitpee SL. L. it; ekGo 337 1 License# I <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I <br /> I License # <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address ( I License # I <br /> OTHER Company I <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address <br /> License # <br /> Directions:,,, <.a•E. >,.. ..., .. ., <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 />