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si 3-�so-oo2o City of Zephyrhills Fire <br /> " Permit Application Fax-813-780-0021 <br /> )ate Received <br /> ` ' " ,�,;,,�„� ._ Phone Contact for Pertnit �� <br /> Mmer's Name f 1�. cCS � �+�.�.., , , d. x �_ .,. -. � �>g� - _ .. . .. <br /> Owner's Phone Number C� �� � <br /> hvner's Address <br /> 'ee Simple Titleholder Name � �� ^—� <br /> Titleholder Phone Number j j <br /> �ee Simple Titleholder Address `____J <br /> c_. ..�:;�,:.M; w.w�� <br /> c �, . <br /> S =��a�_�,kn.s�a?� �.�s <br /> lob Address Ze � (�'t' �t. �,�'7$ <br /> v �� <br /> iub Division Lot# <br /> , ,. � r;�,.:.,,_.: ,�, Parcel# <br /> • ^ - . ,_ a'"�a"3 m �. . . .�. �.��aw,�ac <br /> � Bio-Hazard Waste Storage-ANNUAL � .� °"s ��„ <br /> � Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum <br /> � Hood Installation <br /> Emergency Generator<30 kw � <br /> � LP/Natural Gas-installation <br /> Emergency Generator>30 kw � <br /> aLP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL a <br /> Places of Assembly-ANNUAL <br /> ❑ �Y emi � er <br /> Sprinkler � � � ❑ <br /> Recreational Bum <br /> Fire Alarm � ❑ ❑ p � ❑ <br /> Sparklers <br /> Hood Cleaning � � � � ❑ ��/� <br /> ❑ Sprinkler System Installations ' /�i / <br /> Hood Suppression p � � � ❑ �y( � <br /> QStandpipes(Sprinkler Sys) ��� <br /> Fire Alarm Installation � <br /> a Torch Roofing/Tar Kettle <br /> Fire Pumps � <br /> ❑ Waste Tire Storage ANNUAL <br /> Fire Works <br /> � FlammabieApplication-ANNUAL <br /> � Fuel Tanks Valuation of Project <br /> QOther: <br /> �.,a... . � F. e������.:.�a <br /> x. <br /> .,�,�$, <br /> ontractor <br /> ignature Company <br /> Gi � ( r <br /> Address <br /> Registered Y/N Fee C nt Y/N <br />_ECTRICIAN <br /> License# �— <br /> gnature Company <br /> Address <br /> Registered Y/N Fee Cunrent Y/N <br /> UMBER <br /> License# <br />�nature Company <br /> Address <br /> Registered Y/N Fee Current Y/N <br /> License# <br />:CHANICAL <br />�nature Company <br /> Address <br /> Registered Y/N Fee Current Y/N <br /> HER <br /> License# <br /> nature Company <br /> Address <br /> Registered Y/N Fee Current Y/N <br />�ctions: <br /> 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(Mecha�ical 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� ppraiser.pascogov.com) <br />