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a�s-�8o-002o City of Zephyrhills Fire <br /> Permit Application Fax-813-780-0021 <br /> Date Received <br /> � ��s . ,, _ , W _ ^ , , Phone Contact for Permit <br /> Owner's Name � �� - � � ,t.,. -. ;�- ,�.._�..K. �.,... - . , ...,.. . _ $ - � - . .. <br /> ` � �� � <br /> � �n T'�'n- Owner's Phone Number <br /> Owner's Address � p l / <br /> � V ���_j c '/ L��� ��• � c., �( S L <br /> ��� <br /> Fee Simple Titleholder Name � � �� <br /> Fee Simple Titleholder Address Titleholder Phone Number <br /> �,: . w � a�n.,�. <br /> +�"R. a �tE' 3 <br /> Job Address <br /> �' . . ��'�rq. z. <br /> Sub Division <br /> Lot # C� <br /> � F..� , .,:..:�,-� ,�_, ,�,�, _ , Parcel # <br /> _ ` . , � . - �'� :.—, <br /> � �� .'�'i;.e�f6g�_a a . - _ <br /> Bio-Hazard Waste Storage - ANNUAL � �����:*x�t <br /> � Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Matenal (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � <br /> � Hood Installation <br /> Emergency Generator < 30 kw � <br /> � Emergency Generator > 30 kw �P/Natural Gas-Installation <br /> � Fire Protection Maintenance - ANNUAL � �P�Natural Gas-ANNUAL Sale _ <br /> � Places of Assembly-ANNUAL �� � `� <br /> ►ry emi � er <br /> Sprinkler � �/ � � � ❑ � i <br /> ❑ Recreational Bum 1r �� �! J 9G� <br /> Fire Alarm � � � �� ❑ - ��� � � � <br /> ❑ Sparklers <br /> Hood Cleaning � � � � ❑ <br /> ❑ � Sprinkler System Installation � <br /> Hood Suppression p � � ❑ <br /> � Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation � <br /> � Torch Roofing/Tar Kettle <br /> Fire Pumps <br /> � '� Waste Tire Storage ANNUAL <br /> Fire Works <br /> � Flammable Application- ANNUAL � ��Iy � <br /> � Fuel Tanks Valuation of Project <br /> Q Other. . .. ._ _. .. .�.. <br /> ' -�'Sx`wah'.. ,.: v3?nx.;s': y .rFa» d�,�%. � .vG�.'�-;":ti:fi+�'d.sg't4t`�: M , -.^- -... °� -, <br /> R 7�Ti'.�d'S•.0 , .y�A�.a�s.:+wS^ n «: •`l+ir#'.,.Y,.yzY.:a<_:.• .x,`a � <br /> ontractor � �.-�-:�:.�� *�.��,��c:�a�.,,�,.-.,�. <br /> i � �^�.���. �,<-�--,:� - � <br /> ignature � , �`�, '7 � Co pany /�4 � <br /> gistered / N Y / N <br /> Address Fee,iC�f`rent <br /> _ECTRICIAN icense # <br /> gnature �� <br /> Address Registered Y/ N Fee Current Y/ N <br /> .UMBER <br /> License # � <br /> �nature Company <br /> Address Registered Y/ N Fee Current Y/ N <br /> :CHANICAL License # <br /> �nature Company <br /> Address Registered Y/ N Fee Current Y/ N <br /> HER License # <br /> nature Company <br /> Address Registered Y/ N Fee Current Y/ N <br /> �ctions: License # <br /> Fill out application completely <br /> Owner & 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 #- obtained from Property Tax Notice htt //a <br /> � P� ppraiser.pascogov.com) <br />