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s1�7saoo2o City of.Zephyrhills Fire Fax-613-780-0021 <br /> �Permit Appiication <br /> . . <br /> Date Received Phone Contaot for Pertnit ~ � <br /> „xs�:szsuc;rr��^s�r.�aa.�:�.�...,.��.:.�w�.,:..,.,�...r.. �..,s�,,�.V.�....,,... �.,�..�„w.�, <br /> � t <br /> Owner's Name Owner's Phane Numbar �. � <br /> Owners Address <br /> Fee Simple Titlehoider Name Titlehalder Phone Number �.� � <br /> Fee SimpleTiUeholder Address <br /> �,":, <br /> ` JobAddress � � � a-� /l � J Lot# � <br /> Sub Division Parcel # <br /> ^ � BiaHazardWasteStorage-ANNUAL � Fumigation?ent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardaus Material (Tier II or R4 Faailiiy) ANNUAL <br /> � Controiled Bum � Hood instgilatian <br /> � Emergency Generator < 30 kw � LPfNatural Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Natuca3 Gas-ANNUAL 5ale <br /> � Fire Protpction Maintenance - ANNUAL � Places of Assembfy-ANNUAL // � I�f �� <br /> .�r y emi �n er ,� f � <br /> 5orinkler � ❑ ❑ C7 � � Recraetional Bum <br /> � <br /> Fire Alartn � � ❑ ❑� a Sparklers <br /> Q�i/j%� � Hood Claaning f�; ❑ ❑� � Sprinkler System Instaflations <br /> Hood Suppression �❑ � ❑� � Standpipes (5prinkler Sys) <br /> � F?re Alarm Instailation � Torch RoofinglTar Kettle <br /> � F�re Pumps � Waste Tire Storage ANNUAL <br /> F+re Warlcs <br /> Flammat�ie Application ANNUAL � � Valuation of Project <br /> Fuel Tanics <br /> Q Other. <br /> �� <br /> Contrector Campany <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address t License # <br /> ELECTRICIAN rj Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> 5ignature Registered Y/ N Fee Current Y/ N <br /> Addrass License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/(�! <br /> Address License # <br /> OTHER Company <br /> Sianature Registerad Y/ N Fee Current Y/ N <br /> Address License # <br /> . . .u:«w`.m:rN��-"==.-- � .. . <br /> Directions: <br /> FII out application compietely. <br /> Owner & Contrector sign back af appfication, notarized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement fs required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documantation <br /> Allow 10-'14 days for review after submittal date. Parcel #- obtai�ed from Prnperty Tax Notice (http:/lappreiser.pascogov.com) <br /> -�--- � � , � l � C �+-- �r � � � �- � ' U U eCY,C' h �/YI e . <br /> � �� � ' 2�) i � � � 3 s� Z <br /> � � � r�� l�s �L <br /> �-_� �� � � �� ��- �E� � �� <br /> ��f� , � .i�, �, , /�, �,� �.��o� : <br />