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,� sis-7so-oo2o City of Zephyrhills Fire Fax-a�saso-oo2�
<br /> � Permit Application
<br /> Uate Recerved � Phone Contact for Permit �;17� 4 2 q�13
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<br /> Cw;.ers Name O �,10l�A�C� Ir 1�11l.hG �(kK� Owner's Phone Number 3T,� ��� ����
<br /> Gwner'sAddress �3��� ��O�T K(l�l�i �A� �AU�e�-C9 ��- ?!?lJ�/+7
<br /> ree S�mple Titleholder Name Cr Titleholder Phone Number �� � �
<br /> r �c,r.-,n�e Tiileholder Address C
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<br /> Job Address !,7�� �i�+�.�✓ �L���Y��/�fi �'/f/LL S 33s4�/ Y��1 �ot# �'
<br /> Sub Division �- ParCel�t
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<br /> � Bio-Hazard Waste Stor.age-ANNUAL Q Hazardous Materiai�er II or RQ Facility)ANNUAL
<br /> � Comm Exhaust Kitcher�HoodlDuct � Hood InstallaUOn
<br /> � Controlled Bum � LP/Natural Gas-Installation � �,L
<br /> � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sale 'y � 7
<br /> � Emergency Generator:>30 kw � P�aces of Assembly-ANNUAL ( �
<br /> � Fire Protection Maintenance-ANNUAL U ReCreational Burn
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<br /> Spnnkter � ❑ ❑ � � � Sparklers
<br /> Fire Alarm � ❑ O � � � Sprinkler System fnstallations
<br /> Hood Cleaning � � ❑ � � � Standpipes(Sprinkler Sys)
<br /> Hood S�ppression � ❑ ❑ ❑ � � Torch Roofing/Tar Kettle
<br /> � Fire Alarm Installation a Waste Tire Storage ANNUAL
<br /> � Fire Pumps
<br /> Fire Works
<br /> � Flammabie Application•ANNUAL Valuation of Project
<br /> � Fuel Tanks
<br /> �] Other �— �
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<br /> Contractor �� 2� Company �� i{ I u'4'1'o/,�ir� �
<br /> S�gnature Registered Y/N Fee Current Y/N
<br /> Address 3531 kB ,}�Ai2. Re�. LiCense# EFOODOy�� �
<br /> ELt CTRICIAN Company
<br /> Signature RegiStered Y/N Fee Current Y/N
<br /> Hddress � License# �— �
<br /> PLJ��16tR Campa�y ��
<br /> Sg�arure � � Registered Y/�1 Fee Current Y/N
<br /> Adaress LiCense# ���
<br /> h7 E C HAN I CA L �Ompany
<br /> S�gratu�e Registered Y/N Fee Currant Y/N
<br /> Adaress r License# �
<br /> �7H F k Company ��
<br /> S�gnature � Registered LY/N Fee Curr�nt Y!N
<br /> AC�ress UC2nse# '��
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<br /> F�il out application<;omptetely
<br /> Gwner 8 ConVactor sign back of apphcation,notarized(Or,r_opy of sigr.ed contract wdh owner)
<br /> if over 32500,a Not�ce of Cominencement is required(MeChaniCal work over 55400)
<br /> Suppiy two(2)sets of draw�ngs wrth applicable documentanen
<br /> Allow 10-1a uays for review after submittal date. Parcel#-obtained from Propsrty tax No6ce(httpJ/appreisecpascogov.com)
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