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813- 780 -0020 City of Zephyrhills Fire <br /> Permit Application Fax- 813 - 780 -0021 <br /> Date Received J ( I LI t9 I <br /> Phone Contact for Permit <br /> Owner's Name I itA 4 — C 4....)6TO A►ek CO‘ k;31 Q I O - <br /> Owner's Phone Number I /5S 11782 I I t ‹K f /( <br /> Owner's Address 152- S L{ - '1 <br /> Fee Simple Titleholder Name I I <br /> ' Fee Simple Titleholder Address I Titleholder Phone Number I I I I I I <br /> r / ; <br /> Job Address 2-614 L f 57 235-4 I <br /> Sub Division 1 J l J I Lot* <br /> ..; ,rr:,,:.s.f Parcel # <br /> =� ry., :., <br /> I ,; _ r az spa #E ,...ta <br /> Bio- Hazard Waste Storage - ANNUAL ,e: �'•r �, ,, , , 4, - - , w ; <br /> I I I Fumigation Tent <br /> Comm Exhaust Kitchen Hood /Duct u Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum I <br /> Hood Installation <br /> Emergency Generator < 30 kw I <br /> LP /Natural Gas - Installation <br /> Emergency Generator > 30 kw <br /> LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL <br /> I 1 Places of Assembly- ANNUAL <br /> I I p D Iutrlyl 'Semi � (uther I <br /> Sprinkler I I <br /> Recreational Burn <br /> Fire Alarm O 0 ❑ I J <br /> Sparklers <br /> Hood Cleaning 0 0 01 i l l <br /> Sprinkler System Installations �,(l( <br /> Hood Suppression n •p 0 0 I J ❑ <br /> Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation <br /> 1 Torch Roofing/Tar Kettle <br /> Fire Pumps u Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application - ANNUAL <br /> 1 Fuel Tanks <br /> 3• o -- I Valuation of Project <br /> Other: I r4 „ 4.. S &C./ A S <br /> Contractor - - .tom x,_ _ <br /> Signature .` /�` '� I Company <br /> Registered Y / N . 1 Fee Current I Y/ N 1 <br /> Address 4 L 0 , ,yam <br /> ' ' r , — License # I I <br /> ELECTRICIAN' <br /> Signature Company I y.,G f� G <br /> Registered Y / N -Kee Current I Y/ N <br /> Address I <br /> PLUMBER <br /> 1 License # <br /> Signature I Company <br /> I Registered Y/ N j Fee Current I Y/ N J <br /> Address J <br /> 1 License # <br /> MECHANICAL' <br /> Signature I Company <br /> Registered I Y/ N J Fee Current I Y/ N <br /> Address I <br /> 1 <br /> License # I J <br /> OTHER <br /> Signature I Company <br /> Address <br /> Registered I Y / N j Fee Current 1 Y/ N <br /> j ons : ._. .._: License # <br /> Directions: a'.--.zay c•t * tta ^ .Raat•+„z.aa� �.'�auue`s <br /> ?: a edm:;;;a. a ....,:.:x: a <br /> Fill out application completely. m "d'' • °,- J —��' x� <br /> Owner 8 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 it - obtained from Property Tax Notice htt //a <br /> ( p: ppraiser.pascogov.com) <br />