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ai3-�so-oo2o City of Zephyrhills Fire <br /> - Fax-813-780-0021 <br /> Permit Application <br /> ate Received � _ S f I <br /> . , _;. Phone Contact for Permit �� �� <br /> nvner's Name �i✓�L/1/f�J'— Q �D <br /> Owner's Phone Number � �� �� <br /> L� <br /> nn�ner'sAddress GffL[ Q��/� ZL/�✓�f�//'/�j2C1• /-=� 3js�/� <br /> ee Simple Titleholder Name �� � �� <br /> Titleholder Phone Number <br /> ee Simple Titleholder Address <br /> - �z � -_'�` -.�;,�.=z�w;a- ... <br /> �b Address � <br /> Lot# <br /> ub Division <br /> Parcel# <br /> � Bio-Hazard Waste Stora.-e. ..._. .�,,.;. .....�F ��„-_ '_ ...°��_.- r>_ ::- � ,<.�. �..�° �� ;��.��.,,;�.sa��,��a�* .�-� -. �.,z . , <br /> g -ANNUAL � Fumigation Tent T� <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LPlNatural Gas-Installation � l�� <br /> Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL � ' <br /> Places of Assembly-ANNUAL <br /> � ry emi � er ❑ � <br /> Sprinkler ❑ O Recreational Bum � �� <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers � <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations �\ <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) `��-�� ��� <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � FlammableApplication-ANNUAL <br /> QValuation of Project <br /> Fuei Tanks <br /> Q Othef: <br />"__ —- -c�. ""�, �__ _ _ , �'i „v'°`3�,. s. .,.,_ .. � r..R".x�F.F;+P';. <br /> �Y6�'e"}'• <br /> ontractor � w _ .«. ._ , s, r , S:.°„ . ..^.tF T.-�"-. '§.�.Ci"�q'V� � -.-h='4F3^g,,.�„zr,. :",Y81. .d:4 <br /> ignature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> LECTRICIAN <br /> gnature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />_UMBER <br /> gnature Company <br /> Registered Y/N Fee Cunent Y/N <br /> Address <br /> License# <br />_CHANICAL <br />�nature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> HER <br /> inature Company <br /> Registered Y/N Fee CuRent Y/N <br /> Address <br />�ctions: License# <br /> Fill out application completely <br /> Owner 8,Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice htt //a <br /> � P� PPreiser.pascogov.com) <br />