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Fax-813-780-0021 <br /> City of.Zephyrhills Fire• <br /> e�s-�8o-002o Permit Application p <br /> ��� Q� Q� `Z Phone Contact for Pertnit�� �J'r J ^ / 3.5 <br /> �. _...... �..t..:.�y...�.>_...,_.___ <br /> �ate Received� ` � __ <br /> i �. �-�-:�...��.'-�.°` � .3 S/ <br /> �•.V.v�.:::�����.....��,.�.. ��0 1�'�t%� �/3 5� <br /> ���,..� ` Owners Phone Number <br /> )wner's Name L <br /> � , �G x � � � ��� � 0 0 <br /> )wners Address � <br /> TiUeholder Phone Number <br /> ee Simple Titleholder Name <br /> �-�.��� <br /> ee Simple Titlehaider Address �� - '�� <br /> ����.�.�-� 379/� � �or� <br /> ob Address <br /> -��;��iU ,� ,u� ����1 � ��� <br /> Parcel# _�: <br /> �ub Divisio� <br /> �� � Fumigation Tent <br /> � Bio-Hazard�Naste Storage-ANNUAL � <br /> � Hazardous Material(Tier II or RQ Facility)ANNUAL � <br /> Comm Exhaust Kitchen Hood/Duct � „� <br /> � Hood Installation //� <br /> Controlled Bum � ��/� <br /> LP/Natutal Gas-Installation � � <br /> aEmergency Generator<30 kw a `p/N3t��r�l Gas-ANNUAL Sale <br /> � Emergency Gene2tor>30 kw � p�aces of Assembly-ANNUAL <br /> � Fire Protection Maintenance-ANN� em' � er <br /> ❑ � � � � Recreational8um <br /> Spri�kler �� a <br /> ❑ � � � Sparkters <br /> Fire Alarm a <br /> (��' ,_,/ � � � Sprinkler System Installatio�s <br /> Hood Cleaning U 'v � <br /> ❑ � � � � Standpipes(5prinkler Sys) <br /> Hood Suppression <br /> a � Torch RoofinglTar Kettle <br /> Fire Alartn I�stallation � <br /> � Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> � Fire Works Vatuation of Project <br /> aFiammable Application-ANNUAL <br /> � Fuel Tanks <br /> a Other- r— <br /> � Company � s "S T fCc <br /> �ontractor Registered Y/N Fee Curtent Y/N <br /> ��� <br /> Signature <br /> License# <br /> Address <br /> Company Y/N <br /> ELECTRICIAN Registered Y/N Fee Current <br /> Signature � <br /> License t� <br /> Address <br /> Company <br /> PLUMBER Registered Y/N Fee Current Y/N <br /> Signature � <br /> License# <br /> Address <br /> Company Y(N <br /> MECHANICAL Fee Current <br /> Registered Y/N <br /> Signature � <br /> License# <br /> Address <br /> OTHER Company <br /> Registered Y/N Fee Current Y!N <br /> S ig nature <br /> License# <br /> Address - <br /> Directions: <br /> FII out application completely. <br /> Owner&Contractor sign hack of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Comme�cement is required(Mechanical woric over$5D00) <br /> Supply two(2)sets of drawings with applicable documentation caiser_ asco ov.com) <br /> Allow 10-14 days for review afler submittal date. Parcel#-obtained from Property Tax Notice(http:l/app P 9 <br />