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s���ao-oozo Ciiy of.Zephyrhills Fire Pax-B'13780-0021 <br /> Permit Application <br /> uate Received � Phona�artt��t for PermR � a-���� <br /> .��.�.�n�r�:�;��:s�;.ra�,.y.LL w ..�„�..�...,..W,..�...., � <br /> Owner's Name 1�, � OuRter's Phone Mumber �13-?�.1 ��17 1 I C <br /> 1�� <br /> owner's Address ��f (Q (_,_(„r j� _ ,3 � <br /> Fee Simple Ti±�eholder Nam� i ifleholder Phone Numcer � �__J � <br /> Fee Simpie"T(tleholder Addrr�ss <br /> ;�'. <br /> , <br /> �ob Address �9(�� Q,� ) � �j Lot# C <br /> Sub Dfvision °al'cel# <br /> :;�; + <br /> aBio-l-3azard Waste Storege-ANNUAL � Furnigation Terrt <br /> � Comm cxhaust Kitchen Hoad/Dunt � Hazarclaus Materiel(Tier fl ar RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Install�'�on <br /> � Emergency�eneratar•=30 kw � LP/hlatural G�s-Inst2llation <br /> � Emergency Generator>30 kw � lPlfVattrral Gas-AN1dUAL Safe <br /> � Fire Pratection Maintenance-AhINUAL � Places of Assembly-ANWUAL <br /> ny emr `�Tn er <br /> Sprinkle� � G „_, ,_., �J L Recreaflonai Bum <br /> Fire,41arm � G ;� C1 � � Sparklers � , <br /> / <br /> Hood Cloantng � ❑ ❑ C� � Spnnkler System Instgllations �� ����1� <br /> Hcoci 5uaprassian ❑ G � �� � 5tandpipes(Sprinkler Sys) ` � / <br /> QF�re Alarm 3nstailation � Torch Rooflng/TarKattle , .-�'' <br /> � Fire?umps � WastB Tire 5tor2ge ANNUAL <br /> Fire Works <br /> �lamma�,le Apolication-ANNl1AL Vaivation of Project <br /> Fuei Tanks <br /> � C}tn : <br /> �3r�;c:�,� � � <br /> Cor.-ractor ! 1— Cornpeny �� <br /> Sigrature ' Registered N Fee Currant Y N <br /> Addr=ss (' License# <br /> _LECTRICIAt�I Cempany <br /> Sicr,ature �_ Registared Y/N Fee Curtent Y/N <br /> Addrass License# <br /> PLUMBER Company <br /> Signature � Registered Y/l�l Fae Gurtent Y/N <br /> Addrass I License� <br /> "JF_CHANICAL Company <br /> ^�,-�'-;'G i � Reglstered � Y / N � Fae Current Y/ N <br /> Address � Lfcense# <br /> �"��R r Company <br /> Si�nature <br /> Rsgistered Y/ N � Fee Current Y 1 N <br /> Ad�ress License# <br /> PLniNJ4�fwIGMf�ilkW:uf.BLlo�b::9ptleII •".^"��• _`.nu�:..fidYfW'l�LLMYY•••._••••••.•,••9kYtlpOyyN. �Srw'i <br /> Direc±icr,s: <br /> FII ou:ap�lica'tion completely <br /> Owne�'R Con^actor sign back of 3nplicetion.rotanzed(Or,ropy of signed contreaY with owner) <br /> if over$25D�,a Ncti�e of Cnmm�n��ment is r6qwred(P.fechanica!wo*k over�500D) <br /> Sunnly�f.wo!2;sets ef dra•.a-i.r.p�v�rh e+pc�,iesnie deeumpntatior <br /> F,Ilow 1C?-?�d�ys?or revier,v�F;�-<u�mitts(r,�,�;. !�arc�i�t�-a�tainad�from Prepa!Yy T�Nctice(htfp:l/appraissr.nasccgov.comj <br /> �� ��--- �-�.�J�!��7-+-�- �"`lr'1 ;,{i�� � �_ �' �J� C�GY.C'.Li T '�1'I� • - <br /> ��.i � _t� . ` ' - � _ ' ,� � � `,'�i= <br /> � [,,�f � � ,� ��� `�-�- ,�f,���� �-��� ,-�� ll.s �L <br /> V � �� / � J <br /> /�l /�// I � <br /> / /��7 i' ,/��A . // -/ l/1/T 1 ��� ! <br />