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May. 26. 2010 11:12AM FIRE FIGHTER, INC No. 8245 P. 2 <br /> 813- 79 - Q020 tatty of Zephyrhills'Fire • Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received S 7— V • Phone Contact for Permit <br /> Owner's Name pI n ( DIVA/ Owner's Phone Number 1 ' II fila I t41 <br /> Owner's Address I LAS s 6A II 131Y <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address CASs � i /) . • . . <br /> 1>IW Loth <br /> Sub Division I Parcel # <br /> .._ _,..._.., .i.. _�_... .. _ *' IIIAt�9lllBlBil .�1®tlA9iNlttYASR' IW111Crf;irA4ry7M' <br /> E Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> L.J Comm Exhaust Kitchen Hood/Duct I Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> Ei Controlled Bum El Hood Installation <br /> Q Emergency Generator < 30 kw = LP/Natural Gas - Installation <br /> Emergency Generator S 30 kw 0 LP/Natural Gas ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> Lila LIM 1E1 MOM <br /> Sprinkler Lj f] ❑ O ID Recreational Bum <br /> Fire Alarm E ❑ ❑ ❑ 11 = Sparklers <br /> Hood Cleaning E ❑ ❑ ❑ 11 E Spnnkler System Installations <br /> Mood Suppression 2 D o v"I1 E Standpipes (Sprinkler Sys) <br /> a Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> I I Fire Pumps n Waste Tire Storage ANNUAL <br /> n Fire Works <br /> Flammable Application- ANNUAL <br /> H 1 I Valuation of Protect <br /> Fuel Tanks <br /> n Other I I <br /> Contractor Company , ^ ' U Signature / LAA Registered � � . a � F• ®Current Y / N <br /> Address • I o 'RAIIIII I IMIllr' 1�1MIEriKil License# 0 0 OO'-b 1 CLIME. <br /> ELECTRICIAN Company I <br /> Signature Registered Y/ N I - Fee Current I Y / N I <br /> Address I _ I License # I <br /> PLUMBER Company I <br /> Signature Registered I Y/ N I Fee Current I Y/ N I <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address I I License # I I <br /> OTHER Company I <br /> Signature Registered Y / N J Fee Current I Y / N J <br /> Address License # <br /> Directions: - ... :.....:... <br /> Fill out application completely. <br /> Owner & Contractor sign beck of application, notarized (Or, copy of signed contract with owner) <br /> tf over 52500, a Notice of Commencement is required (Mechanical work over 55000) <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: /Jappreiser.pascogov.com) <br />