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s�s-�ao-oozo Cifij of Zephyrhills'Fire� Fax-813-780-0021 <br /> Permit Application <br />)ate Received �— �_ - Phone Contact for Permit <br />.�a5_�_e�k.s:it.:�:��::,o.,..,.�.,.�..s....«. . �����.s+t� a�'e�..���,u�-�.w� ,........,�_..�,...�-�,�,�..�....�.....,e�� <br /> hvners Name SS cti � � S Ovmer's Phone Number o ( ?j � <"5� <br />)wners Address � � y \. � " � �O�`� <br />=ee Simple Titleholder Name TiHeholder Phone Number � � � <br />=ee Simple Titleholder Address <br />�i�"'mss"-.:i:��"'s�.:����"'a�"'s:'6�9t� t aa�wn��.� .�$t�(�'���i",�ia�'��13".rJ.a�,i�.?�"'.�''�m°�y,�3a <br /> Job Addr=ss � ,'�j..7 � � � 'e `� 1r� Lot# � <br /> Sub Division � Y Parcel# (� �1-a(p ��� — f)U� � "�oU� -D rJ � <br /> i�':�'a:^z�'a:.s�rFt��sr.v£4�'r�"�yy'. , �tF"�""""�_�°'�mr A.... �k'�:li$�:e�",�'i'�_d�5_.°e:�:�c,:�:�&E.:zf_;t..c;_�:�'=�s <br /> � BiaHazard Wast�Storege-ANNUAL � Fumigailon Tent <br /> � Comm Exhaust 1Ctchen HoodlDuct Q Hazarclous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled 8um � Hood Instailatlon <br /> � Emergenny Generator<30 kw � LP!Naturel Gas-Instaliation �" <br /> Emergeney Generator>30 kw � LPINatural Gas-ANNUAL Sala � <br /> Fire Protection Mairttenance-ANNUAL � Places of Assembly-ANNUAL y � � �j <br /> �y emi �n ar �/ � <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum /J/�� �'' ' <br /> L% ��% <br /> Fire Alarm � � ❑ �! � � Sparklers <br /> Hood Cleaning ❑ O /❑ � a SprinklerSystem Installatlons "`---------~ <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys} <br /> aFire Afarm InstallaUon � Torcfi RoofinglTar Kettle <br /> Fire Pumps � Waste Tfre Storage ANNUAL <br /> Fire Works ' <br /> Flammabla Applicatlon-ANNUAL Valuation of Project <br /> Fue{Tanks <br /> Q Other; <br /> P�:�����:��� �.�.,..��.w��-�.•��:�°z� <br /> ConVactvr Comparry � ',• + � •� � ':�r�-' - 6. <br /> Signature ' Registered Y N Fee CuRent N <br /> Address a 1� �], - � � '- f'' License# �t�, i c:3 <br /> ELECTRIC�AN Company <br /> 5ignature Registered Y/N Fee Current L Y/N <br /> Address �icense# <br /> PLUMBER Company <br /> Signature RegiStered Y/nl Fse Curtent �(/N <br /> Address Licensa# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address �— License# <br /> OTHER � Company <br /> 5ignature Registerad Y/N Fee Current �'/N <br /> Address �— L1Cense# <br /> '.�-.���f - -� •- �• +ev`_�a.�cw..x�ri:myiuv'.Gee.�+..�:aotsur ••y•--uraH.�.�.r..�....ye�:3uuivaway.n...suS�f�r2eYlT.� ._ ., . ..�_.�_s.__._.,...��__.._.._._. ._v"'�+:r.��,r,7.y9C': <br /> Directions: � �� J � �� <br /> Fill aut application completely. <br /> Owner 8 Contractor sign back of applicatior�,notarized(Or,copy of slgned cvntraet with owner) <br /> If over�2500,a Notice of Commencement is required(Mechanical work over a5000) <br /> SuppYy two(2)sets of drewings with appiicable documentation <br /> Allow 10-14 days for review aiter submittal date. Parcel#-obtained from Property Tax Notice(http:llappraiser.pascogov.com) <br />