|
rrom: ' ��-�? ll S�C��-� � �Pl °J �-e�2.1�'tl't .. .__ . .-- ---
<br /> ��
<br /> 813-780-0020 City of Zephyrhills Fire ��� � Fax-813-780-0021
<br /> — Permlt Applicatlon � � r►'1 D� r�A
<br /> . ,
<br /> , �
<br /> Data Received aKU_�� / c, .:...:: z<_:a-w,,•M:., w ......�... CA111tCtfG r x r ,a a ���xyr.�.r„��!•,!'� . ..,,.. . _.<_.3. .,�....... .., .. ,.
<br /> ax,�:•�.a::::�:,�:,r.s,.,..:c :.... ..�. ,
<br /> Phone Pe
<br /> , ..,
<br /> ,::.. ,:.. �;,.::.,f, ;._ .
<br /> Owners Name , , , .- ., . . '. .... F^ pwne�e Phone Numbar r�� � �
<br /> Owner's Add►ess
<br /> Fee SimFsle TlUeholder IJeme Tltleholder Pho� Number �,� � r
<br /> Fee Simple Titlehofdar Address
<br /> � y� . . . xSmE+S'�ts:w.r!'i'h0?Ya::vb.�:�':x'Ax!�4rp+�7.�}4i'"%�':�h'��afw��'.dR§d
<br /> -.� .:;:�t;�.�s::tc^s:;�cwtl'.n.�.�?�RF*za'H�&a,!.`S'c�0.H.se� "-',�'�tu.8`:r`�ty's:5�.'y�';,.
<br /> Job Addross -3 S Z� r1 �. ' ' � ( S r �— 3 � �' � � Lot #
<br /> Sub Dlvlaion Parcel #
<br /> .•+ ,. .. av e,tirbtr:?.�aRri+Ya�+`R'��'eF� Bt4tt%6Y�Y��'�"�di;2M'Sb)i3C'�F.a�:.`k.. 1��..� ��a:F'.:=S54i�!Fi'bL:tR4M.:1;fiNrtAiE"%:2i]17.'ctix'i'^.A4'�3�%'dSa.X`aF`. "9d�6tl:n��f'�ati%4'i%'k°"ald4'.".3$;rHY57++'II]:iN4''+S"L?".':n
<br /> � Bio-hlatard Waste 3torage - ANNUAL � Fumigation Terrt
<br /> a Comm Exhaust KlLchen HoodlDuet Q Hazardous Matariaf {Tfar il or RQ Facflity) ANNUAL
<br /> O CoMroiled Bum O Hood Insfeflation
<br /> a Emergency Cienerator < 30 kw o LP/Natural C3aa-Instal{etlon ��� ��*�,
<br /> Q Emerpency Generator> 30 kw � LP/Natural Gaa-ANNUAL Sale ,, l �
<br /> � Fire Proiection Malntenanca - ANN� �� r O P�aces of Assembly-ANNUAL �— � j�� � f�
<br /> � � �.
<br /> Sprinkler � � ❑ ❑ � RecreaUonai Bum ,
<br /> Fire Wamt � � ❑ O � Sparkiara _S �� V I�'� �
<br /> Hood Cleaning �❑ ❑ ❑� a Sprinkler Syatem InsfallaUona
<br /> Hood Suppressfon � ❑ ❑ O� Q StandPipea (Sprinkier Sye) ,� � Z�% J�
<br /> Firo Alsrm InstaUstion � Q Torch koofihg/Tar Kettle
<br /> ' Q Waste Tire Storoge ANNUAL
<br /> Fire works
<br /> Flammsble Applicatfon- ANNUAL r2�, � �— g, Z 3, Valuation of Projed
<br /> Fuel Tanks i.J � t ��� NL � � ���1 z� SM i Th
<br /> ... ,...: :�:Ga:v'r��aav,t� , v `'.�'� r :L"u"rnn.�'a%=35kktim.IdLi�•?.'A,�`.Y�S.e' ( tzilaiK'RaaYi�'�`t.'a'bw^m+:'�?�se::wtae.aa t .:�`.at< ,1 c:.::h"?a':. ,; cx!'."� �%�:.1ta:��rE�t'�°r�:k",a'M�:7':A:cr,,4FS&C'44.2^JL+dfi.i#s2l`�tic�'�`Yt�edit.�7ia5:::lS7.tw1A'lYvrrw;.'s.�ir
<br /> COfItrHCIOf 4 )/� COfTlpBfi�/ � /�'1
<br /> g��� �! /' -� Registered Y/ N Fee Curtert Y/ N
<br /> Address Ucense # p t�
<br /> ELECTRICIAN �PeM'
<br /> 3ignature � Regfstered Y/ Id Fee Current Y/ N
<br /> Address Lioense #
<br /> PIUMBER �mPa�Y
<br /> g�g„ature Regieterod Y/ N Fee Cirrent Y/ N
<br /> qddress License #
<br /> MECHANIC �mPa�Y
<br /> s�gr,ature Reg�stered Y/ N Fae current Y/ N
<br /> Address Lkanse #
<br /> OTHER Company
<br /> Sipnsture Registered Y/ N Fea Currort Y/ N
<br /> Address Licenae #
<br /> ..,. , . .:..•.. , ..:.:..:............:... �,..:,a .,,..�.:=:,.._::t.{ ...�: ; •�
<br /> o rc....,n... . ..,.:..: � �y_:.�., uHx,...;. ....:...�.. ,.,,..,.,_.�..��.,n.,.� .r, .,,....,. �...,... .... _...�cr,r.•,•.. ..,.:Mxr.sz:<r.:.
<br /> Dlrectlo�s: ,. ,.. ,. ........ .._.,...__.....
<br /> FlII out appitcatlon complstely.
<br /> Owner & Contrnctor sign back of appqcatlon� noTarized (Or. copy of signed contrad with owner)
<br /> N over 32500, a Notic�e af Commenoemenl Is requMed (AAechanlcai work over $5000)
<br /> Supply two (2) aets of draw(nya wfth applicable dacumer�taUon
<br /> Allow 10-14 days for review after suGmlttal date. Parcel #- abtained from Property Tax Notice (http:/Jappraiser.pascogov.com)
<br />
|