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s��-�so-oozo Ciry of Zephyrhills Fire Fax <br /> Permit Application <br /> Date Received "f ^ r Phone Contact for Pertnit N ���� <br /> Owners Name C ( rC Owners Phone Number C� �� <br /> Owner's Address a I <br /> Fee Simple Titleholder Name Titleholder Phone Number � C� �� <br /> Fee Simple Titleholder Address <br /> - ., ,., ��:,. :,� : z:>��: zs�; � � _ <br /> �=z��:�:�R;�°�.#�v�����-: : f,� <br /> Job Address �� � � �(/�O a // ✓ (.�f �� <br /> Lot # <br /> Sub Division Parcef # <br /> . . 4.�� � ,,,�. �s w�<�;�: �..��;.=,.,�:,:� � ..� . , , . <br /> . ,,... ::• s° s" �:�rr�r 9.:.sxk::; .�r�:w • <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL S � <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-A UAL ��� <br /> ❑ rTy emi �n er � � <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> FireAlarm � ❑ ❑ ❑ �� � Sparklers _�_._ <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ � ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofinglfar Kettle <br /> a Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> Contractor Company r ` �f �on <br /> Signature Registered / N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature � Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> Directions: ' ' <br /> Fill out application completely <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contrect 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 (http:/lappreiser.pascogov.com) <br />