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s��7so-oo2o City of.Zephyrhills Fire Fax-813-7g0-0021 <br /> , �Permit Application <br /> Date Received Phone Contact for Permit � � <br /> .- �°.;�-....�.�s«a�•.;..- ., <br /> Owner's Name /� Owners Phone Number g �� �� I�ti�-j r•, j� <br /> I! �S.�J,_ <br /> Owners Address 3 L� � � .t"�` <br /> Fee Simple Titleholder Name TiUeholder Phone Number � � � <br /> L.� <br /> Fee SimpleTitieholder Address <br /> �t�,. <br /> Job Address '� l.-�— ���}'� �1� � Lot# C <br /> Sub Division Par�el# <br /> p � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm E�chaust Kitchen HoodlDuct � Hazarrlous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL 5ale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL ��/ � <br /> CI�Tr y emi �n er � <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum �r <br /> �� J <br /> Fire Alartn � ❑ ❑ D � � 5parklers n Z <br /> �Ho-od Cleaning � ❑ ❑ � � Sprinkler System Installations �J r " � <br /> ,��,.-�u C� ,�i"� <br /> Hood Suppression ❑ ❑ p � � Standpipes(Sprinkler Sys) td V�"' � p�� <br /> � Fre Alarm Installation � Torch RoofingRar Keme �(�;C''�� �g � <br /> � Fire Pumps � Waste Tire Storage ANNUAL �1Y�, ��e�r <br /> � Fire Works �'�f-� ��c 1D <br /> Flammable Application-ANNUAL Valuation of Project <br /> � FuelTanks <br /> Q Other: <br /> Contrector Comparry sJ � y" <br /> Signature Registered �I CY��N I Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registerad Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICA Company <br /> 5ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> Directions: <br /> FII 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 Commencament is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documerrWtion <br /> Ailow 1 D-14 days for review after submittal date. Parcel#-obtained frnm Property Tax Notice(http:/lappraiser.pascogov.com) <br /> -�- �.. P 1�CS�-�!i� � �" Z��C� ec�,c� ��'�e � <br /> �1a; ( �� � <br /> � C!� _ '] _ � / / � � S�Z <br /> .�7 � � � � �'` ��� �Fe j L��� rLt, �ls' �G- <br /> /`���? -` ,C�Gt C-��� � � <br /> �� � � <br />