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a��-�saoo2o City of Zephyrhills�Fir�- Fax-e�s-�so-oo21 <br /> � • Permit Application <br /> �te ��a - Pno�;e c«,�c ra �� 27 2 e 2 <br /> _ .. . - .«,x..e..W.,�.��.�:�.� .� <br /> Ovmers Name C�vners Phone Number �3 1��� Q2 Z <br /> o,�rs aaa� D 2 I�� l/ . � rL • 33S / <br /> Fee Simple Titleholder Name Titleholder Phone Number ��� <br /> Fee SimpleTitleholderAddress <br /> JobAddress 2�� G�` l 3 3sq 1 Lot# � <br /> Sub Division Patcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent � <br /> o Comm Exhaust Kitchen HoodlDuct � Hazardous Material (fier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LPMaturai Gas-instaliatlon <br /> � Eme►9encY Generator > 30 kw � LPMatural Gas-ANNUAI Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> ��� r <br /> Sprinkier � ❑ ❑ p � � Rec:readonal Bum // / <br /> Fire Alartn � O ❑ ❑ � Q Sparklers % / � ( JV <br /> . / � ( � <br /> Hood Cleaning � f� ❑ ❑� � Sprinkier System instalialio�s <br /> Hood Suppression �❑ p ❑� � Standpipes (Sprinkler Sys) <br /> � Rre Alartn Instaliation � Toreh Roofing/Tar Kettle <br /> Fre Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Applica6on- ANNUAL Valuation of Project <br /> Fuei Tanks <br /> Q Other. <br /> contractor <br /> Comparry <br /> Signature Registered Y/ N Fee Cumerrt Y/ N <br /> Address � # <br /> ELECTRIC <br /> ���Y <br /> signature Registered Y/ N Fee Current Y/ N <br /> Address V�� # <br /> PLUMBER �� <br /> siynature Registered Y/ N Fee Cumerrt Y/ N <br /> Address Vicense # <br /> MECHANICAL �� <br /> S'g"ature Registered Y I N Fee cument Y/ N <br /> Address License # <br /> OTHER �� � C <br /> Signature Registered N Fee currerrt N <br /> Address p x W ucer�se # <br /> Directions: " <br /> FII out application completely. <br /> Owner & ConUacbor sign back of applic�tfon. notsm.ed (Or. copy of signed contract wfth owner) <br /> If over 52500. a Nofice of Cort�rtiencemertt is required (Mechanical wwk aver f r N) <br /> Supply two (2) sets of drawings wfth applicable documer�tation <br /> Allow 10-14 days for review after submittal date. Part:el #- obtained ftom Properly Tax Notice (hUpJ/appraiser,pascogov.com) <br />