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`81�-780-OG20 City of Zephyrhills Fire Fax-813-780-0C21
<br /> Permit Appiication
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<br /> Owner's Name (-� - r+-j = Z.,— Owner's Phone Number � �� �
<br /> Owner's Address �� 'Y��� - �/(> ' �(��' J� M L/aC/-1 � �j i�Q g
<br /> ree Simolz Titieholder Name Titleholder Phone Number �� ��
<br /> Fee Simpie i itl=holder Address
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<br /> Lot€
<br /> Sub Division 35-�5 �
<br /> Parcel� < � - .� bZ> OG�d
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<br /> � Bio-Hazard Waste Storage-ANNUAL � Fumiaation Tent . .� ^
<br /> � Comm Exhaust Kitchen HoodlDuct , � Hazardous Material(Tier II or R�1 Facility)ANNUAL
<br /> � Controlled Bum � Hood insta�ia'tion
<br /> � cmergency Generetor<30 kw a LPiNatural Gas-Installafion
<br /> � Emergency G=nere'tor>30 kw � LP/Natural Gas-ANNUAL 5ale
<br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �
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<br /> Sprinkler �� lJ
<br /> � � °� ❑ � Recreaiional Bum ! �
<br /> Fire Alarm 0 ❑ ❑ Sparklers
<br /> Hood Cleanmg � r, ❑ ❑ C� � Sprinkler System instaila6ons
<br /> Hood Suppression � ❑ ❑ ❑ �� � Standpipes(Sprinkler Sys}
<br /> � Fire Atarm installation � Torch RoofinglTar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � Flammable Appiication-ANNUAL Vaivation of Project
<br /> Fuel Tanks
<br /> � Other:
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<br /> Contractor � "' '
<br /> Company
<br /> Signature Registsred Y/N Fe�Current Y/I�
<br /> Address
<br /> License# ��
<br /> �LECTRICIAN Company
<br /> Sigrature Registered Y/N Fee Current Y/N
<br /> Address License� �—
<br /> PLUlviBER
<br /> Company �—
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address
<br /> License�
<br /> M�CHANICAL Company
<br /> Signature Registered � Y/N � Fee�Current Y/N
<br /> Address License# —�
<br /> OTH�R Com an
<br /> Signatur= � '��� �,� �`, P Y p� L�,e - c- 2 CtiTC C 7 r,yv �',v�
<br /> Registered � �„/N Fee Current /N �
<br /> Address � L
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<br /> Directions' "' � " -
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<br /> Fill out application completely � 3/ � -��a o U�2 v� 3
<br /> Owner&Contractor sign back o`application,notanzed(pr co �p
<br /> py of signed contract with owner)
<br /> I�over�2500,a Notice o`Commencement�s required(Mechanical work over$5000)
<br /> Supply two(2)sets of drawings with applicable documentation
<br /> Aliow 10-14 days ror review after submittal date. Parcel�-obtained from Pro ert Tax Noti�e htt //a
<br /> P Y � F� PP'aser.Pascoaov.com)
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