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ais-�so-ooza <br /> * City of Zephyrhills Fire <br /> Permit Application Fax-813-780-0o21 <br /> Date Received <br /> ' - - _ Phone_Contact for Permit ���- q y z �q�3 <br /> Owner's Name E�'�TL/3�(, �CQ /yJgNo2 C'A,�,� <br /> 3�aao Owner's Phone Number p�3 78� ���t/ <br /> Owner's Address ��y �� 1/._!D 2� T <br /> �T a ��l�Vi�f/CLS F� 335Y�- <br /> Pea Simple Titleholder Name �� <br /> Fee Simple Titleholder Address 7'itleholder Phone Number �� �---J <br /> J <br /> Job Address 3�e�a p, f�Ei,/,2y ,/�2 .zEoyr2��c c s f�=-=3 3ST� <br /> Sub Drvision Lot# � <br /> - - _ Parcel# � <br /> � B�o-Hazard Waste Storage-ANNUAL � � - - ' <br /> � Hazardous Material(Tier II or RQ Facility)qNNUAL <br /> Comm Exhaust Kitchen Hood/DuCt � <br /> � Hood Installation <br /> Controlled Burn a <br /> � LP/Naturai Gas-Instaliation <br /> Emergency Generator<30 kw a <br /> � LP/Natural Gas-ANNUAL Sale <br /> Emergency Generator>30 kw � <br /> � Fire Profection Maintenance-ANNUAL ?�aces of Assembly-ANNUAL <br /> try emi � � �ecreational Bufn <br /> t er <br /> Sprinkier � � � ❑ <br /> ❑ Sparklers � n/ / � <br /> Fire Alarm � � � � ���p c�� <br /> � <br /> � � � Spnnkier System Installations <br /> Hood Cleaning n O � ❑ <br /> ❑ Standpipes(Sprinkler Sys) <br /> Hood Suppreggipn � � � � ❑ <br /> oTorch RoofinglTar Kettle <br /> Fire Alarm InstallaUon a <br /> � Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> � Fire Works <br /> � Flammable Application-qNNUAL <br /> � Fuel Tanks Valuation of Project <br /> [� Other: <br /> Contractor - -- - --. _ ._ _„_ _ , <br /> Sigrature Company -r- � <br /> Registered Y/(�� Fee Current Y/N <br /> �adress 353 f � �oh <br /> c�ECTRlGAN License# q�g 5��0� ���z <br /> S�gnature Company � <br /> Address �-- Registered �Y/N J Fee Current Y/N <br /> PLUMSER License# � <br /> Signature Comp�ny M� <br /> Address Registered Y/Pd Fee Current Y/N <br /> MECHANICAL License# <br /> S�gnarure Company - <br /> Address Registered Y/N Fee Current Y/N <br /> vTHER ; License# � <br /> � <br /> =:gratur� ' Company <br /> Address � Registered Y/N Fee Current Y/N <br /> Cirec'�ons: -- _ _License# � <br /> Fiil out application Cpmpletely <br /> Own2r&Contractor sign back of application,notarized(pr,copy ot signetl contract with owner) <br /> If over 52500,a Notfce 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. Farcel#-obtained from Property Tax Notice(http:/lappreiser.pascogov com) <br />