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a��-�aaoo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received �� � Phone ConFact for Pertnit (?j �� ) � O <br /> Owner's Name C h r h►( S Owner�s Phone Number � 3 7�'o� 35Da` <br /> o�,�rg o�a� �S� lv Gfr II a � � d " Z h � h � 1 s� L 3�� <br /> Fee Simple TiUeholder Name Titleholder Phone Number �� � U <br /> Fee Simple Titleholder Address <br /> Job Address � I`� �� (3 � J lJ► � Ze h r l� I ls 3 4a y q Lot # � <br /> Sub Division Parcel # <br /> a Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Dud � Hazardous Material (Tier II or RQ Faality) ANNUAL <br /> CoMrolled Bum � Hood Insfailation <br /> � Emergency Generator < 30 kw � LPMatural Gas-Installation <br /> � Emergency Generator > 30 kw � LPMaturai Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL a Places of AssemWy-ANNUAL <br /> 4�ed,� I� c( � � � j <br /> Sprinkler � ❑ ❑ ❑ � � R��b� Bum ' � ` / / � � � <br /> � Fire!�►i° � ❑ ❑ ❑ �x % <br /> _ �� ❑ Sparkiers � I <br /> � /� � I � I tiood Cleaning � � ❑ ❑ ❑ � � Sprinkler System InsNallations <br /> '/� ;{, � �PPressi� Y�'1 � ❑ ❑ � � StandPiPes (Spri�kler SYs) <br /> ` 1 6 � `�c� <br /> � Fire Alartn Installation � 3^-�� �, � Torch Roofinglfar Kettle <br /> Fire Pum l' l< <u <br /> � a Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL <br /> Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor 1,` l , Company <br /> Signature w a'1 n� V j g � L ` <br /> Registered Y/ N Fee Current Y/ N <br /> Address � o 'Z <br /> License # <br /> ELECTRICIAN ��� <br /> Signature Registered Y J N Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER Company <br /> signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y! N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: <br /> Fill out appliption completely <br /> Owner & ConVactor sign back of application, notarized (Or, oopy of signed contra�t with owner� <br /> If over 52500, a Notice of Commencement is required (Mechanical work over $5000) <br /> SupplY lwo (2) sets of drawings with appliqble documentabon <br /> Allow 1a14 days for review after submittal date. Parcel #- obtained irom Property Tvc Notioe (http://appraiser.pascogov.com) <br /> v���L nvc <br /> x�a;a� � � . p h � � � � : <br /> r.o. � zr,�►s7 �'� � � �(�.t � tN --i3 <br /> P: s F: i��..+.l3,�.i�A � � y� �Zy �CuJI� � <br /> g���sC�'�.�, j�,,,,�x� < <L 33te � �I <br />