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813- 780 -0020 City of Zephyrhills Fire 1,r/04 l/(/ !` Fax -813- 780 -0021 <br /> Permit Application <br /> Received J -Z a Phone Contact for Permit I c13 1 1 9 6ci I.7 77 S <br /> er's Name I CUR f r) 1 C.Grlite R21 CL c t`, I Owner's Phone Number I I -3 -782. 1 /, [7 1 <br /> er's Address G (_0 Lo ao a - z E PI-N r- t-1 1 LL 5 3 3 55'1 <br /> Simple Titleholder Name Titleholder Phone Number <br /> Simple Titleholder Address I <br /> 4ddress ZL-yI?I(���5 -FL. X3 Lot# <br /> Division y 1M&L -1 j,i Z NATtu g I Parcel # 12-- Z 6 9 " 21 — )2() — 0c)'(W — 0 1 R <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 Burn n LP /Natural Gas - Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - ANNUAL Sale <br /> I I Emergency Generator > 30 kw n Places of Assembly- ANNUAL <br /> n Fire Protection Maintenance - ANNUAL n Recreational Burn I /� <br /> IQtrly1 1Semi I Other � ? (� f <br /> Sprinkler 0 ❑ ❑ ❑ I I Sparklers VA (►� PJ 0 Fire Alarm El ❑ ❑ ❑ I I I Sprinkler System Installations u „j 1 <br /> Hood Cleaning El ❑ ❑ ❑ I I [] Standpipes (Sprinkler Sys) (� 5 v <br /> Hood Suppression El ❑ ❑ E I I I I Torch Roofing/Tar Kettle <br /> I1 Fire Alarm Installation I I Waste Tire Storage ANNUAL <br /> F - 7 Fire Pumps <br /> I Fire Works <br /> n Flammable Application- ANNUAL I _7 ( ,j I Valuation of Project <br /> Fuel Tanks <br /> I Other: 1 <br /> ractor Company I <br /> ature Registered Y / N I Fee Current I Y / N I <br /> Address ( License # I <br /> DTRICIAN Company <br /> ature Registered Y / N I Fee Current I Y / N I <br /> Address License # <br /> MBER Company <br /> ature Registered Y / N I Fee Current I Y / N I <br /> Address 1 I License # <br /> :HANICAL Company <br /> ature Registered Y / N I Fee Current I Y / N I <br /> Address 1 I License # <br /> ER ature Company <br /> c <br /> atu 7 G ( �?�1J,.A I` Registered Y / N Fee Current Y N <br /> Address IDES N'1.t k Oil ICI CIA_ ( Zo I License # C • SQ. _ • <br /> :tons: W`Z � 1- Y if (, j f L 33 Yy <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 />