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813-780-0020 City of Zephyrhills Fire Fax-ais-�ao-oo2,
<br /> � - Permit Application
<br /> Date Received � --��.-1
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<br /> hone Contact tor Permit 9 ti 2 I q
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<br /> owne�sName Z�l�t,l�ftCG(,S l96idOS�'/'/�, /j(�/�(�, Owner'sPhoneNumber ��e� 7/$� j�sd0
<br /> Owner s Address �73�3 ���A�S ��-O� �,� ,Z�,P,��us �L �j�S1I�
<br /> Fee S�mple 7ittehoider Name Titleholder Phone Number C] � ��
<br /> fee S��mpie TitleholderAddress
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<br /> Job Address / '��� �9�i�/t/ -.J(�j0�'iS V+� /� /T�� �JUf/v �d� ��J 5�� - �-' - 1.�._J
<br /> � Lot#
<br /> Sub Division
<br /> Parcel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL � Hazardous Material�er il or RQ Facilihi)ANNUAL
<br /> � Comm Exhaust Kitchen Hood/Duct a Hood tn5tallati0n
<br /> � ControAed Bum � lPlNaturai Gas-Installation
<br /> � Emergency Generetor<30 kw � LP/Natural Gas-ANNUAL Sale
<br /> � Emergency Generator>30 tw � PlaCes of Assembly-ANNUAI /1
<br /> aFire Protection Maintenance-ANNUAL Q ReCreaUonal Burn � J� �7 � �
<br /> a �Y emi � er �",' �
<br /> Spnnkler � � LLf'
<br /> ❑ ❑ ❑ Sparklers t I
<br /> Fire Alarm � ❑ ❑ �, � � Sprinkler System Installations
<br /> Hood C�eaning � O ❑ � � ❑ Standpipes(Sprinkler Sys)
<br /> Hood Suppression � ❑ O O � � Twch Roofin
<br /> � g/tar Kettle
<br /> Fire Alarm InstaUation a Waste Tire Storage ANNUAL
<br /> � Fire Pumps
<br /> Fire Works
<br /> � Flammable Applica6on-ANNUA� ��
<br /> � Valuatiori of Project
<br /> fuei Tanks
<br /> [� Other
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<br /> Signature Company -j' ,},u� �u �„9'Q
<br /> Registered Y/N Fee Current Y/(� �
<br /> Add��ss 35 31 l�,e ,},on� Rd.
<br /> License# F.F 000�{�I 1
<br /> t_L!_ClRICIAN
<br /> S�gnature Company
<br /> Registered Y/N Fee Current Y/N
<br /> Atldress
<br /> License# �—�----r`�
<br /> PL'JM3ER
<br /> S�gnacur� Ce,apany
<br /> Registered Y/N Fee Current Y/N
<br /> i�d�^.IF;SS
<br /> License�
<br /> MECHANICAL -
<br /> Signature Company
<br /> Registered Y/N Fee Currant Y/f�!
<br /> Address
<br /> License#
<br /> 07NER
<br /> S,gnature Company
<br /> Registered Y/N Fee Current Y/N —�
<br /> Address
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<br /> Gdl out applrcat�on comptetely �
<br /> Owner&ConVactor s�gn back of appllcation,notarized(Or,copy of signed contract with owner}
<br /> Ir over 52500,a Notice of CommenCement is reqwred(Mecharncal work over g5000)
<br /> Supply ewo(2)sets of drawings with appiicable documentation
<br /> Auow 70�4 days for review after submittal date. Parcel#-�utained from Property Tax Notice(http:!/appraiser.pasc+x�ov com)
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