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s��.7ao-aozo City of Zephyrhills�Fire� <br /> Fax-813-780-0021 <br /> Permit Application • <br /> )ate Received Phone Contact for Permit��_ <br /> ;��s�r:<��::-..�i�:��.�,....V�.....,,,a.,�:«�.�, - - �m� <br /> ... .. °��x' �=y'"�,'��� <br /> hvner's Name � UM1er5 Phone Number � -( /X�,! ! �� <br /> Ll�`�J <br /> )wner's Address � � u , Z � � 3 3 e� <br /> ., <br /> �ee Simpla Titleholder Name Titlehoider Phone IVumber C� � <br /> =ee Simple Titleholder Address <br /> s.�' -''m',L's'rs�.S;�:��s��me-a, <br /> �+=,a� ,� <br /> ?#�" :c�`�"'�-.:�i�}"a.:��".,,.�riau��sai�:�r�'?'�°i:�'*��r-�it,:; <br /> 1ob Addr=ss � <br /> Lot# <br /> 5ub Division <br /> Parcel# <br /> '�w.-"'�"-.'�.�,•�a;.r t�asa7�s..—_•�x��—�'a���".��ses,:�rsn�-,��, <br /> � �'3��„�""�`�sa_.L'.'�.�`.4��e-m✓"xd^iscba"r��n°�.��.F��;:%u`st::��:::::°:,r�'�c7 i-�'x..�'.s.. <br /> Bio-Hazard Wast�s 5torege-ANNUAL � FumigaUon Tent <br /> � Comm Exhaust FCtchen HoodlDuct � Hazardous Materia!{Tier If or RQ Facility}ANHUAL <br /> � ConVolled 8um Q Haod installation <br /> � Emergency Generator<30 kw � LP/Naturaf Gas-Installation <br /> Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale /�/� j ��J / <br /> Firs Proteation Mairrtenance-ANNUAL � Piaces of Assembly-ANNUAL �f'/ / 3 l <br /> ❑ �Y emi '�n er � � <br /> Sprinkler ❑ ❑ p Recreatlonal Bum <br /> Fire Alarm � p p � � � Sparklers <br /> Hood Cleaning p p ❑ � a Sprinkler System Instaliatlons <br /> Hood Suppressii�n � p ❑ p �� � Standplpes(Sprinkler Sys} <br /> QFire Alartn Installation � Torch Roofingffar Kettle <br /> Fire Pumps � Waste Tire 5torage ANNUAL <br /> Fira Works <br /> Flammable Application-ANNUAL <br /> Fue(Tanks <br /> Valuation af Project <br />�,,�_. <br /> � Other: <br /> Contractor - "p�����:x:.2�� <br /> Signature _ Comparty " �,•�. , .= ,� ` ,jrd �. <br /> Address a �c RegistersiJ Y N Fee Cutrent nj <br /> \� - � ` � '-'�'� Ltcense# ti <br /> ELECTRICIAN `��" �� <br /> 5ignature Company <br /> Registered Y/N Fee Current Y/T— <br /> Address <br /> PLUMBER License# �-- � <br /> Signature Company � <br /> Address <br /> Registered Y/N Fee Current Y/N <br /> Llcense# '� <br /> MECHANICAL <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> O7HER License# �— �'—"—'I <br /> 5lgnature Company <br /> Registered Y/N Fee CuRent Y/PJ — <br /> Address � <br /> r-fa����- . . �_-�.y::�.:�.�,����.:.,�.u.. License# <br />�irectians: - - __, __ � <br /> Fill out application campletely. ���r� �� �s '���� <br />