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a�3-�saao2o City of Zephyrhills Fire Fex-813-780-0021 <br /> '� � Permit Application <br /> Date Received -� Phone tec C� <br /> :._. ._ ,.,...: ... . .:...... -- - --------=--- -- -- =-- - -- - - -- <br /> . .. <br /> _ .,..,.�.__ ... . �-, . --.. . . . .._...._ <br /> - � -------•- ----------- °n t w Permit _ .__.. _ � -- - ----- -.::....__ -._-- <br /> Owners Name � �CeDeI � ,� �� S �/JL Owners Phone Number �_] �� �] <br /> Owner's Address �7�7� / C L � �� ,3�,,,``�' ZS' <br /> fee Simpte TiQehotder Name Tideholder Phone Number �� � C� <br /> Fee Simpte Tfilehotder Address <br /> _ ._.. ._ <br /> .__,_,...---. <br /> - - - - - -- --- - -=-- - --- - <br /> -------- - �- - - -_--_.:. ------• <br /> Job Address Lot# �� <br /> Sub oiv3sion Parcel# <br /> -- - �- � - - - ----- -- -- - - - <br /> _ ._ . - _ , _ _ _ . ..._.__-�------------ ��; <br /> a 8ialiazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen FloodlDuct � Hazardous Material(TEer II or RQ Facilityy ANNUAI � <br /> Q Controlied Burn � Hood Inslallatlon L��(� . �E+1� <br /> � ��^ <br /> � Emergency Generator<3Q kw Q LP/Natural Gasdnstallation �.�, <br /> � Emergency Generator>30 kw Q LPMetural Gas-ANNUAL Sale 0 <br /> � r <br /> Fite ProtecHon Maintenance-ANNUAL � Places of Assembly-ANNUAI. Si3 � <br /> �y emi � r g ��I <br /> Sp�nkler � I] ❑ ❑ � � Recrsational Bum ���j'� <br /> FireAiarm � � ❑ ❑ � � Spariclers <br /> Hoa4 Cleaning O � Cl � � Spri�kler System InslailaGons `#r��I�ii <br /> Haod Suppression � � � O � � Star�dpipes(Sprinkler Sys) <br /> aFire Alarm installaGon Q Torch Raofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Fiamtttable Appl[CaUon-ANNUAt Valuation of Project <br /> Fuel Tanks <br /> Q �lhef: <br /> Contractor � Company ,� . �. _�_.._.�_._._---. -. .._,. , <br /> Signaiure Registered Y/N Fee Current Y/N <br /> Address Ucense# <br /> ELECTRlCIAN Company <br /> Signeture � Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLlftulBER Company <br /> Signalure Registered Y!N �ee Current Y/N <br /> Address l.icense# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Cunent Y/N <br /> AdBress License# <br /> OTIiER Company <br /> Signature Registered Y/N Fee Current Y!N <br /> Address License# <br /> - - -- ---_._,..,_._,_,,..--,---..:� _ : _ _. . - --- .. . - - - <br /> DirecUons: � - - - -"--- ---- - <br /> Fili out application completely. <br /> Owner&ConUactor sign Uack of apptication,notarized{Or,copy of signed oontract with owner) <br /> If over a2500,a Notice of Commencement is required(Mechanicai work over$5000) <br /> Suppfy iwo(2)sets of drawings with applicabte documentalion <br /> Allow tU-14 days for review aiter submiltal date. Parcet#-obiained trarn Ptaperty Tax lVo6oe(hltp:/lappraiser.pascogov.aom) <br />