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813.780-0020 <br /> City of Zephyrhills Fire <br /> / Permit Application Fax - 813 - 780 -0021 <br /> Date Received ) 2 / i / 0 <br /> ( Phone Contact for Permit <br /> Owner's Name /_' �M P a /4 aA- I I <br /> {{ Owner's Phone Number 11 I I <br /> Owner's Address I 3 i 15-' E, / „,,, I 8 _/ 33 z <br /> Fee Simple Titleholder Name I I <br /> Titleholder er I Phone Number I 1 1 1 I <br /> Fee Simple Titleholder Address <br /> u :,> m li <br /> Job Address q y <br /> Sub Division I I <br /> I Lot # I 1 <br /> :. ,�sY3';cs"Y ' ,�r:2dd%t+s`,� xA .i .. =mQ:. +r - �;.: , , ...,. rx.a Parcel # <br /> `° «- i,. xzs,�..., 4 z d ztz <k � . ' ate” 'n PS { t 3' efr4-Xxt iuFtdt n.R e,"st t. 3., s,:. <br /> I Bio- Hazard Waste Storage - ANNUAL I I <br /> I I Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct L__1 Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum I <br /> n Hood Installation <br /> Emergency Generator < 30 kw 1 I <br /> LP /Natural Gas - Installation <br /> I I Emergency Generator> 30 kw a <br /> LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL I I <br /> Places of Assembly- ANNUAL <br /> 'Utrly' ISemi1 ! 1 Other <br /> Sprinkler ❑ ❑ ❑ <br /> Recreational Burn <br /> Fire Alarm ❑ ❑ ❑ 1 1 1 I Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I 1 1 1 <br /> Sprinkler System Installations <br /> Hood Suppression b ❑ X <br /> I I L _ J Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation I I Torch Roofingfrar Kettle <br /> Fire Pumps I I Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL I <br /> Fuel Tanks <br /> ed© 1 Valuation of Project <br /> n Other: I <br /> Contractor __... _ _ _- J ,w..., <br /> Signature s Company (7`/`e. / , /Ac— <br /> Registered MN I Fee Current I Y / N <br /> Address lirt,9 ,J ita1, <br /> - , , 0 1 -' _ ; p License# I <br /> ELECTRICIAN' <br /> Signature I Company <br /> Registered Y/ N J Fee Current 1 Y/ N <br /> Address I <br /> PLUMBER <br /> 1 License # I <br /> Signature I I Company I <br /> Registered Y/ N J Fee Current 1 Y / N i <br /> Address 1 J I <br /> License # I <br /> MECHANICAL' I <br /> Signature Company <br /> Registered Y / N I Fee Current I Y / N <br /> Address 1 ( <br /> License # I <br /> OTHER <br /> Signature I Company <br /> Registered Y/ N I Fee Current ( Y / N <br /> Address I <br /> s � E• ., License # <br /> Directions: x�ra c :. ..� s 4 n g: < <br /> �r. ta .. ,. n � 1 4 .,., <br /> All 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 htt //a <br /> ( P� ppraiser.pascogov.com) <br />