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. � a��-�ao-oozo City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit Application <br /> Dale Received Phone Con18c1 tor Permit � C� C� <br /> Owner's Name Owners Phone Number ��� <br /> o�rg nnare� d ,P <br /> fee Simple TiUeholder Name Tidehdder Phone Number ��� <br /> Fee Simple Tilleholder Address <br /> Job Address /� � I� �;1 � Lo� � � <br /> Sub Division Parcel � <br /> � Bio-Hazard Waste Storape - ANNUAL � Fumigation Te�t <br /> a Comm Exheust Krtchen HoodJDuct � Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> � Concrolled Bum � Hood Inatallatlon <br /> � Emergency Generator < 30 kw LPlNatural Gas-Installation <br /> Emergency Generator > 30 kw LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL Q Placea of Assemby-ANNUAL � I 2 V�1� <br /> � �� � � � <br /> Sprinkler � ❑ O ❑ � � ReCteadonal Bum <br /> Fire Alarm � O ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ d� � Sprinkler System Insta{lations <br /> Hood Suppression � O O ❑� � Sfandpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofingJTa� Kettle <br /> a Fire Pumps O Waste Tire Storage ANNlIAL <br /> � Fire Wo�lcs <br /> Flammable ApplicaGon- ANNUAL �j� �(,Q Valuation of Project <br /> � Fuel Tanks <br /> Q Other: , ' � ,�ir cr.e� .9TRS✓x T,�4(�� <br /> Contractot Compeny <br /> Signature Registered Y I N �ee Cunent Y/ N <br /> Addresa License � <br /> ELECTRICIAN Compeny <br /> Signature Repistered Y/ N Fee Curcern Y! N <br /> Address L�cense # <br /> PLUMBER Comparry j G. <br /> Signature Reqistered Y/ N Fae CurreM Y! N <br /> Address License f <br /> MECHANICAL �pmpe�y �� <br /> Signature Reyistered Y I N Fee Cuneat Y/ N <br /> Address V��ye g <br /> OTHER Comparry <br /> SipnaWre Registeried Y/ N Fee CurreM Y! N <br /> Addreas License # <br /> Directions: <br /> Fill out application complelely. <br /> Owne� & Contractor sign back o( application, notanzed (Or, copy of signed conMact with owner) <br /> Ii over E2500, a Notice o( Commencement ia required (Mechanical work over 55000) <br /> Suppry two (2) sets of drawings with applicade documenlation <br /> Allow 10-14 days for reviaw atter submittal date. Parcet #- abtai�ed from Properry Tax Notice (http:!lappraiser.pascopov.00m} <br /> SOOf�j XVd 9E�5T TTOZ/6Z/90 <br />