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<br /> ' City of Zephyrhills Fire
<br /> -�' Y I Permit Application Fa -
<br /> � �_� e�� �so oo_,
<br /> Date Received '
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<br /> Owners Name I y�, � ; Ll l� S c � W '� �� .:.� . � wnc� � ,:-,.�-ra�rzcfe--..u::o.�:a ._..._ � �;.��;-�
<br /> �/ r �� t l �-'�� ��' t�� Owners Phone Number I 3 ... L,S � 3_
<br /> Owner's Address �:� 5� �� l\'�' S C] C
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<br /> Fee Simple Titleholder fYame �
<br /> Fee Simple Titleho der qddress Titleholder Phone Number ��
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<br /> Job Addres ? �, - >: �:�:�?���_.�;? �
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<br /> Sub Drvisron I , „
<br /> `� ..., Parcel #
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<br /> Bio-Hazard Was�e Storage - ANNUAL �":=°c.r �� a�� ..f.�.., a...T;,,,.,;'..,.. t+:
<br /> � Fumioation Tent ���� �
<br /> Comm Exhaust Kitchen Hood/Duct
<br /> Controlled Bum � Hazardous Matenal (Tier 11 or RQ racility) qNNUAL
<br /> � Hood Installation
<br /> Emergency Generator < 30 kw �
<br /> � LP/Natural Gas-tnstallation
<br /> Emerqency Generetor > 30 kw �
<br /> � Fire Protection i�lamtenance - ANNUAL LP/Natural Gas-ANNUAL Sale
<br /> �� �� ��� � Places of Assembly-ANNUAL � n 1
<br /> � Y emi � ` � C� _ �-
<br /> ! Spnnkler r j � O O � V �
<br /> ' � Recreational Bum
<br /> ' Fire Alarm a
<br /> � � � � Sparklers
<br /> � Hood Cleanmg � � Q �
<br /> ❑ Spnnkler System Installations /7 f+/ D�
<br /> Hood Suppression � � � �� � ��
<br /> Standpipes (Sprinkler Sys)
<br /> Frre Aiartn Installation �
<br /> Fire Pumps �
<br /> Tonch Roofing/Tar Kettle
<br /> Fire Works �Naste Tire Storage ANNUAL
<br /> Flammable Application- ANNUAL
<br /> Fuei Tanks � Valuation of Project
<br /> Other:
<br /> 7 r�'."�::.'i:�.
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<br /> ContreetOr k 3 ���� �:�
<br /> � w Company E' D v ��
<br /> Signature , S T� 1 v�.�. 5 �,�
<br /> Registered Y N Fee Current Y/(�I �
<br /> Addresa , 1� S7 ` • • � _ _ �-� �i
<br /> EIECTRICIAN � � � � S ��" � �''�''��' � �` Q FL 3'3 (�Z.y License * g�� �
<br /> Signature � 1 � r 3��) 2 - v -- �0 2 Z.� Company
<br /> Address Registered L 1' � N I Fee Current �' / N
<br /> PLUMBER License �
<br /> Signature Company __
<br /> Address Regrstered Y/ N Fee Currenl Y/ N
<br /> MECHANICAL License *
<br /> SiQnature Comaany
<br /> Address Registered L Y/ N J Fee Current Y/ N
<br /> OTHER License # �—
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<br /> Signature Company
<br /> Address Registered � Y� N I Fee Currenl Y/ N
<br /> Di reclions: ............ License �
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<br /> Fill o t application completelY - -- - .,�.�.�., y
<br /> Own r& Contracfor sign baek of applicatio�, notanzed Or, co
<br /> If ov r 52500, a Notice ot Commencement is requ�red (Mechan cal w rk av e�S5000�th owner)
<br /> Supp�y �p (2) sets of d2wings with applicable documentation
<br /> A��eW 10-14 days for review afler submittal date. Parcel #- obtained from Property Tax Notice (http://a
<br /> I PP�iser.pascogov.com)
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