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813-78G-OC20 City of Zephyrhills Fire
<br /> Fax-813-780-002i
<br /> Permit Application
<br /> ` Dat�i�cceived � , —
<br /> .. . Phone Con �;.Lc�l
<br /> - ,,. , , tact fer Permit V��. f_�
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<br /> �wner's Name C / _.� .rr._ � �� �_
<br /> � � ' Owner's Phone Number
<br /> ;:iwner's Flddress � � 4 �� � ' -
<br /> �ee Sirrp�e Titleholder Narne i ' � r� �
<br /> Title!�oider Pho�e Number L
<br /> `°c-Simpl2?itleho!der Address
<br /> ` . , :i". ' ."rt r •+" .,�',.. ° .�'�:,., 'A','�.'',;::?','��."a;+�i�y,�;.:+ _
<br /> .;eb Addresa � Y. �2 c, �j—'--'
<br /> �-�'J �.�. Lot# �_—
<br /> Suh Division
<br /> ,,, Parcel#
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<br /> Bio-Hazard Waste Storage-ANNUAL � Fumi ation Tent
<br /> � Comm Exhaust Kitche�,HcodlDuct � Hazardous Matenai(7ier fl or RQ Facility)ANNUAL
<br /> � Cor,trolled Bum � Hood Installation
<br /> � �mergency Generetor<36 kw � LP/Naturai Gas-Installation
<br /> � �•ne•oency i:2�e•a+c-� °C kw I—� L.Fi�!�ru�a!Ga�-�N�:LiA!S;.le
<br /> � Fire P•otection Mamtenance-ANNUAi a Pfaces of Assembly-ANNUAL
<br /> ❑ r y emi �n er o � �3��
<br /> 5orin�ler ❑ p ❑ Recreationai 8um
<br /> Fire A,arm p ❑ ❑ �� a Sparklers
<br /> Hood leaning �p C ❑ � � Sprinkler System instailations
<br /> Hoo uppression ❑ ❑ C � � Standpipes(SprinklerSysl
<br /> � Flre Alarn!rstallatior� � Torch Roofing/Tar Kettie
<br /> Fire Pumps � Waste Tire Storage ANNUAL
<br /> Fire W�rks
<br /> Fiammable Application-ANNUAL
<br /> Valuation of Project
<br /> Fuei Tanks
<br /> [� af�ier:
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<br /> -�•:,rt.�;��:.;..�r.r�f,-��.'�r�°° .:pt�
<br /> n ractor y ' _�
<br /> S� ra r Registered N Fee Current Y
<br /> Adoress j ' License�
<br /> ELECTRfCIAN Company
<br /> Sigracure ,_,__
<br /> Registered Y/N Fee Current Y 1 N T—
<br /> Address
<br /> License�
<br /> PLUMBER
<br /> Company
<br /> Sigr,ature — Registereo Y/N Fee Current Y/N
<br /> Address � � �"` "�� "
<br /> �------- � License#
<br /> MECHANICAL
<br /> Company
<br /> Sigrature Registered Y/N ree Current Y/N �
<br /> Adciress
<br /> License#
<br /> dTHER
<br /> Company
<br /> Signature Registered j Y/N � Fee Current Y/N
<br /> Address
<br /> License#
<br /> Directions:� � .. , . �,��,, , ,
<br /> Fili out a�plication com�letei ..,, ,. . ". .,»�°, _� ..«_�-.,.,,.at,t:r�r,.r-, �:'sr_
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<br /> Owner&Contractor sign back oF zpplicat;on,notar�zed(Gr,c.opy of signed contract with ownerJ
<br /> If over�2500,a Notrce of Commencement is required(Mechanical work over bS0001
<br /> Supply two(2)se's oi drawines wrth app!icable documenzari�n
<br /> Allow 10-1�days`or review after submiYta'date. Parcel t -ottsined from Prcperty Tax Notice(http:/la�praiser.pascogov.com)
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