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s��-7ao-ao2o � City of Zephyrhills'Fir.e� Fax-813-7so-o021 <br /> �,L'� �'� Permit Applicaflon <br /> )ate Received - Phone Contact for Permit <br /> �...a:,�. �..wY:.....�� � ._.�.. �_,... �_� <br /> is�.'3.:53' ci..r.;;;�"�'yL .m . ' .-. <br /> hvners Name K -�c� �1 � Owne�s Phone Number � I��� �� <br /> Tnmer's Address �J � � � � <br /> =ee Simple TiUeholder Name Titleholder Pfione Number �� C <br /> =ee Simple Titlehvlder Address �, �.��z <br /> � - �ac# C <br /> Job Address v <br /> Sub Division � Parcel# ''� - � "� - �G '���� <br /> �n..����,zm�� <br /> � <br /> � BiaHazard Waste Starage - ANNIlAL � FumigaUon Tent <br /> � Comm Exhaust Iatchen HoodlDuct a Hazardous Material (Tler �I or RQ Facility) ANNUAL <br /> � CoMrolled Bum � Hood Installatlon <br /> � Emergency Ganerator < 30 kw a LP1Natural Gas-Insta11a8on <br /> Emergeney Generator> 30 kw � LPlNatural Gas-ANNUAL Sale �- <br /> Flre Protectton Mairtenance - ANNUAL a Ptaces of Assembly-ANNUAL - /,,, � <br /> �r'�y em� � r � � � {G' <br /> Sprinkler � ❑ ❑ ❑ � � �reational Bum �� � . <br /> Fre Alartn Q a � Sparklers <br /> Hood Clesning � ❑ O ❑� a Sprinkler System Install <br /> Hood Suppression � O ❑ ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alartn installatlon � Torcfi RoofingfTar Kettle <br /> Fire Pumps � Waste Tirs Storage ANNUAL <br /> Fire Wotics ' <br /> Flammable Applicatlon-ANNUAL Valuation of Project <br /> Fus{ Tanks <br /> Q Other: <br /> �� � <br /> ConVactor ^ Comparry � �-�'� - •�- �� L+ <br /> Signature �� �. ' Ragistered Y N Fee Cutrent N <br /> Address 1 � Liceree # �+�3 � c`� <br /> ELECTRtCIAN Company <br /> 5ignature Regisiered Y/ N Fee Cutrent Y/ N <br /> Address l.tcense # <br /> PLUMBER Company _ <br /> 5ignaiure Registered Y 1 N Fee Curtent Y/ N <br /> Address Licensa # <br /> MECHANICAL Company <br /> Signature Registered Y! N Fee Currant Y/� <br /> Address License # <br /> OTHER Company _ <br /> 5tgnature RegiaEered Y/ N Fee Current Y/ N <br /> Address License # <br /> �:'3�.WiHRi6#aTi�:e,m�.� ._._...��,........�.....,�.da as --.--�---...wavn�: :.•• .-._.m.t - . . .� � - wwea�.wxaare�ss�a .._ s.x,u.cer���LIL^.M, <br /> �IfBCtlOf1S: <br /> FII out applicaUon completely. <br /> Owner 8 Contractor sign back of applicatior�, notarized (Or, aopy of a(gnad contract with owner) <br /> if over 32500, a Notice of Commencsment is required (Mechanicat work over 3500Q) . <br /> Supply two (2) sets of drawings with appiicable documerrtation <br /> Allaw 10-'14 days for revfew after submittal date. Parcel #- obtained from Property Tax NoUce (http:Uappraiser.pascogov.00m) <br />