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813-780-0020 <br /> City of Zephyrhills Fire <br /> Permit Application Fax-813-780-0021 <br /> Date Received _/� <br /> - _ Pnone Contact tor Permit �,�'} q y z 1 g Q 3 � <br /> Owner's Name �.�jG /�� �.y� ' �., , <br /> (, //�/glllQ,� �'�9-� <br /> 3�a aa - �wner's Phone Number �i,/7f 7�� 7`l <br /> Owner's Address �uzy �, � �a3a G��5/,�i� <br /> �CLS � �j y c�Z -� <br /> Fee Simple Titlehoider Name <br /> � � �' <br /> Fee Simple Titleholder Address Titleholder Phone Number �� `--'J <br /> JobAddress ��T(-,C�'/�(� �C.� ��l�6� 1..�,c,�i �_ _ �_,__:,_: _:�_ _ <br /> Sub Division �� �� �`� y t/� <br /> Lot# � <br /> Parcei# —�� <br /> aBio-Hazard Waste Storage-ANNUAL ' ''--� ' _ - - I <br /> � � Hazardous Material(Tier II or RQ Facility)qNNUAL <br /> Comm Exhaust Kitchen Hood/DuCt � <br /> � Controlled Burn Hflod Installatinn <br /> � Emergency Generator< a �P�Natural Gas-instaliation <br /> � 30 kw � <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-qNNUAL � °�aces of Assembly-qNNUAL <br /> t�Y emi ,�'� � Hecreational Burn .� � / � l <br /> Sprinkler 1 e� `''f <br /> ❑ � � c � - � <br /> Fire Alarm � Sparklers � <br /> ❑ ❑ � ❑ <br /> Hood Cleaning ❑ � Sprmkler System Instailations <br /> ❑ ❑ � � <br /> Hood S u p p r e s s i o n a � Standpipes(S pri n k l e r S y s) <br /> � � � � � Torch Roofing/Tar Kettle <br /> Fire Alarm Installation <br /> ❑ Fire Pumps � �^/aste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Applicacion_qNNUAI <br /> � Fuel Tanks Valuation�f�ro�ect <br /> Q Other <br /> Contractor � ._ ,__ <br /> Signature Company ' - <br /> T'�— <br /> Aadress 3g3� K� +0„ Registered Y/N Fee Current Y/N <br /> c�ECTRICIqN License# q g �� <br /> Signature Company z <br /> Address Registered �'/N Fee Current <br /> Y/N <br /> �'LUMBER License# r�—"` � <br /> Signature Company <br /> Address . <br /> Registered Y/PJ Fee Current <br /> Y/N <br /> MECHANICAL License# � <br /> S�gnacure Company — <br /> Address Registered Y/N Fee Current <br /> GTHER Y/N <br /> ; licanse# <br />=igra`:ur� � ��'���—. <br /> Company <br /> Address �_ Registered Y/N Fee Current <br /> Y/N <br />�irecuon;. _License i� � <br /> Fill out application�pmpletely - -_ - <br /> Owner&Contractor sign back of application,notarized Or,co <br /> If over 52500,a NoUCe of Commencement is required(Mechanical work over�$5000) �th owner) <br /> Supply two(2�sets of drawings with appiicable documentation <br /> Ailow 10-14 days for review after submittal date. <br /> Parcel#-obtained from Aroperty Tax Notice(http://appraiser pascogov com) <br />