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s��-�ao-i,ro2o Cifij of Zephyrhills�Fire� Fax-813-780-002� <br /> Permit Application <br /> )ate Received - Phone Contact for Permit ��� <br /> :�.s::..._.._•s,����.,.,:: ._.......�. - ---°...�..�,.,�'s'°.r'.,-. - - ���a�c�+����~���.,—.--.'�—`-�,.� <br /> hvners Name � 2 S � Q N � Owner's Phone Numher � �� C�� <br /> )w�er's Address � ^'� � � <br /> =ee Simpl=Titleholder Name TiNeholder Phone Number � � � <br /> =es Simple Titleholder Address <br /> s'��s.''z�'..,.,,.�.'"�s:.�.��."'s�.�'&w� - a��°:�""'"'�"""°'"'=t . �s�"$L7��$��:a���liJlci<F'�'?:f'-^..>i'�sf;F:�'3 <br /> Job Addr=ss Y'Y� '-� Lot# � <br /> Sub Division �,^ � ' Parcel# �� 'p��p •�� • (�'J� U �•���(� <br /> .�-;?�r�-�,�"- �"` <br /> '�s..-""�`- . .q,�.,.�£e�'3n`-�' �'�-. . 'f�:5�`�e.m�''.e�;�.=��em�:SG�.��.'.%9=:s:.i.�::...:�':-�ti.e�=�'�x <br /> aBio-Hazard Wastrc�5torage-ANNUAL � FumigaUon Tent <br /> � Comm Exhaust K�tchen HoodlDuct � Hazardous Material(Tier II or RQ Facility}ANNUAL <br /> � Controlied Bum Q Hood Instaliation <br /> � Emergenoy Gene�rator<30 kw � LP1Natu�al Gas-Installation <br /> Emergeney Generator>30 kw � LP/IVatural Gas-ANNUAL Sale <br /> Fire Protection Mairtenance-ANNUAL a Places of Assembly-ANNUAL . A � /)� <br /> �rTy emi �Tn er � V <br /> 5prinkler � ❑ O ❑ � � Recreational Bum ` <br /> Fre Alarm � ❑ ❑ Sparklers <br /> Hood Cleaning O ❑ � C] � Sprinkler System Installatlons <br /> Hood Suppressiun � ❑ ❑ p � � Standpipes(Sprinkier Sys) <br /> � Fire Alarm InstallaUnn � Torch RoofinglTar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works • <br /> Flammabla Applicatlon-ANNUAL r����, Valuation of Project <br /> Fuei Tanks <br /> [� Other: <br /> 'r`ir�:r�'bc�.Tr��v�.'"s..�'�t'''",fz'�aBK!' - �t�`x'��y.ar,F':n'u�r"`''�'.�+''��--��u-` <br /> Contractor t � -�—�—— � <br /> Signature Comparry � >•'�:,�,#. + �' .�:. 'iC'�t fs, <br /> Registerec! Y �N Fee Cutrent N <br /> Address � 1 c �], _ ' � - f'- License# ��; �v <br /> ELECTRICtAN Compsny <br /> 5ignature Reg(stered Y/N Fee�Current Y/N <br /> Address <br /> Ucense# <br /> PLUMBER � Company <br /> Signature Reglstered �(/(�f Fee Current `(/N <br /> Address �— <br /> License# � <br /> MECHANICAL Company <br /> Signature Registared Y!N Fee Current Y/N <br /> Address �r � � <br /> License# <br /> OTHER � Company <br /> 5lgnature Registerod Y/N Fee Current Y/N <br /> Address � <br /> n;�� ,___� Lioense# � <br /> DirectiDns: ��`�"�"'�� ° '�""`°-� ,.zu s�sa�.=r_�. <br /> ��S8fk4i l�. i.a_.�,_i>__ �,3�"�..�.s,�t�: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of applicatior�,notarized(Or,copy of slgned cvntract with owner} <br /> If tiver 52500,a Noti�e of Commencement is required(Mechanical work over 35000) <br /> Supply iwo(2)sets of drawings with applica6le documentation <br /> Allow 10-14 days for review after suhmittal date. Parcel#-obtained from Property Tax NoUce(http:/lappraiser.pascogov.com) <br />