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a��-7d�-aazo Cifij of Zephyrhills Fire� Fax-8�3-7so-oo21 <br /> Pe�mit Application <br /> late Received � - Phone Contact for Permit ����+►`) yJ/ _ <br /> .�,.:si.i�,sl�..'�t�.��%,�„4 ,_.�,�,,,�.w�.s.o.,.�......,,�..�°°'�`�."'�"'.""��.'.l�Y�L��:t�'"e�a+nr"�'�'��,n.".�s�� .`�:v:..�.�.� •rc.c���..� <br /> }wner's Name � y� �q {'1 �� Ownet's Phone Number �� �� � <br /> �wners Address '�j�.0 �'� �'� ` �' � I � � �- <br /> °ee Simpl=Titleholder Name TiNehoider Phone IVumber �� � C <br /> =eeSimpleTitleholderRddress � <br /> 9�a�'�'.;�#�.'"`"s�.t���...� '� �'Q �''�'�??d�.s5xis��4'�ti�r�?:�.f?��r�,=�3s <br /> Job Addr=ss �Y-� `'�' Lot# � <br /> Sub division � i �(' � Parcel# (�3 ���" d� - ��Q�� ���Ud '��/Q <br />�;'.!::`s-'�r.�.�u��..�-r�-.��e.'3�4.-�w��'r�i. . . '�".6 E..-��5�+ut�a:w�''�";=.b�eP�G;. :..:,_ <br /> m;i"�::a:8};�."•°=;5��:;�'x <br /> � Bio-Hazard Waste Siorage-ANNUAL � Fumigatlan Tent <br /> � Comm Exhaust K�tchen HoodlDuct � HazaMous Material(Tier II or RQ Facility)ANNUAL <br /> � ConVolled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Naturel Gas-Installation ��/'� <br /> Emergency Generator>30 kw � LPlNatural Gas-ANNUAL 5ale � � �Q <br /> Fire Prote�tion Mairttenance-ANNUAL a Places of Assembly-ANNUAL <br /> �y emi �n er <br /> 5prinkler � ❑ ❑ ❑ � a Recreational Bum <br /> Fre Alarm ❑ ❑ � � � 5parklers <br /> Hood Cfeaning O O ❑ � � Sprinkler System Instailations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn Installatlon a Torcfi.RoofingfCar KetUe <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammabla Application-ANNUAL Valuation of Project <br /> Fuef Tanks <br /> Q Ofhef: <br /> Pi��a��,��:.�,�:��:��x��w��� �,� � _ ..... <br /> ----- �7I�@�FJ� �i�'i"�r�•vrwrx-�+�s,°-• �� •��'^•�3arnT!:�a����---,uaxh_',S,�,�:^�,"�v..'°�4i <br /> ConUaotor Com a ' �=' � :�_ ._ <br /> . P �Y �• sd:.].CS2r•a� � ".)t'dvM��fe. <br /> Signature Registereil Y N Fee Current R1 <br /> Address a 1� � � �-•�'° License# '+ <br /> JV ►i� <br /> ELECTRICIAN —'— <br /> Company <br /> 5ignature Registered Y/N Fee Current� Y/N <br /> Address �— Lfcense# <br /> PLUMBER � — <br /> Company <br /> Signature <br /> Reglstered Y/N Fee Current Y/N <br /> Address <br /> Llcense# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y 1 N <br /> Addrass <br /> license# <br /> OTHER � Company <br /> 5ignature Registered Y/N Fee Current Y/N <br /> Address �— <br /> �q�-�:�..— � License# <br /> Oirections: � ag � �,,,Q«..., _ F.�.,,,....�.�,....u�.�ss:� �_ - - --,.�. :,__�_�=,r...ti,.c_at�sa-z:,� <br /> Fill out applicaifon completely. <br /> Owner&Contractor si�n t�ack of applicatior�,noiarized(Or,copy of signed contract with owner) <br /> If over�250D,a Notice of Commencemant is required(Mechanical work over 350[t0) <br /> Supply two(2}sets of drawings with applicable documentation <br /> Allaw 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notics(http://appraiser.pascogov.com) <br />