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s�saso-oo2o City of Zephyrhills Fire Fax <br /> Permit Appiication <br /> Date Received ' � Z� Phone Contact for Pertnit � 3 9� L//� <br /> Owner's !'�/V�.= �r(J i�.s � Owner's Phone Number �� � <br /> Owners Address 7,5 L � (>—� L�— ''v L V J <br /> Fee Simple Titleholder Name TiUeholder Phone Number �� � <br /> Fee Simple TiUeholdar Address <br /> Job Address Lot # �� <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> Q Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier il or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Instailation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale q <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL I j��� <br /> �y em� �n er � I <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ O� � Sprinkler System Installations <br /> Ho pp� s 'o� � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Ala I tallation � Torch Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works � <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks / <br /> Q Other: <br /> . -- .�,�..�,_�- . . . , . <br /> Contractor Company �G ,s ST� n'1 LV lD f- <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address SGtlFJP�Y I _S7� �O S'• F1� - 3 7/( l.icense# —ZO00 <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> Directions: . > , , � V �� � u x <br /> Fill out application completely. <br /> Owner & Contractor sign back of applicalion, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical worlc over $5000) <br /> Supply Mro (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http:/lappraiser.pascogov.com) <br />