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<br /> Ciry of Zephyrhills'Fire� F�-813-78o-aa21
<br /> Permit Application
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<br /> a1e Received � �x��wa��rt*,��+�,,."x�'z��..-�,--�,-r° •.�',""'_ •— -.- .....__..__.
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<br /> r � ` � pwner'S Phone Numbe�
<br /> hvner's Name Y�
<br />)wnePs Address �� 3� 1 r �n�� � � G � �I S �
<br />�ee Simple Titlehotder Name
<br /> TiHeholder Pfione Number � �� �
<br />=ee Simple7iileholderAddress �,�,��:,.��n�,�,�^�����?;�"!:»�d�.��'k
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<br /> Job Address �/ / - �///
<br /> Pareel# b �G4 ' �� ' e:��� ' �l`7�D ' ���
<br /> Sub Division a�sr�s�,e=b�'em��rt;:'•"-'=w=,�:v..�,.`=�-`s£-�=".
<br />�:�:.�-s�.""`y���::��t- ' �
<br /> � eio-Hazard Waste 5torage-ANNUAL FumigaUon Tent
<br /> � Comm Exhaust Kltchen HoodlDuct � Hazarclous Materiai(Tier{i or RQ Farility)ANNUAL
<br /> � Controlled Bum � Hood I�stallation
<br /> � Emergency Generator<3d kw � LP/Natural Gas-Installation
<br /> Emergeney Generator>30 kw � LPINaturel Gas-ANNUAL Sale ��
<br /> Fire Protection Mairdenance-ANNUAL a Places of Assembly-ANNUAL , /�(,{
<br /> ❑�Fr y emi � er a � � J (
<br /> 5prinkler ❑ ❑ ❑ Recreational Bum
<br /> Fre Alartn ❑ ❑ � Sparklers
<br /> Hood Cleaning O O ❑ � a Sprinkler System Installatlons
<br /> �
<br /> Hood Suppression � O ❑ ❑ � Q 5tandpipes(Sprinkler Sys)
<br /> � Fire Alarm InstallaUvn � Torcfi Roofingffar KetUe
<br /> Fire Pumps � Waste Tire Storags ANNUAL
<br /> Fire Works '
<br /> Flammable Applicatlon-ANNUAL Valuation of Project
<br /> Fue{Tanks
<br /> � Other:
<br /> � '"�6 '���.•.�_�' .'�
<br /> 3i����-��..'��'�s't'�?'�' .�- ,,,_.� �f,,,�
<br /> ConVactor Comparry � ��',• •' •� � '�r�•���'•
<br /> Signature � ' Registerad Y 'N Fes Current �
<br /> Address a �� \� - `� � ':'(" Licer►se# Jtti. �v
<br /> ELECTRICIAN Company
<br /> 5ignature Registered Y/I�I Fee Current Y/N
<br /> Address License#
<br /> PLUMBER � � Company _ _
<br /> Signature Registered Y/N Fee Gurrent Y/N
<br /> Address �- License#
<br /> MECHANICAL Company
<br /> Signature Ragistered Y/N Fee Current Y/N
<br /> Address License# �
<br /> OTHER Company
<br /> 5ignature Rsgistered Y!N Fee Curtent �'/N
<br /> Address � L� - -- - �.�,...�,.�s,...�.x_,_._�—r__ti,.�_..i�.���w
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<br /> 61169
<br /> Directions:
<br /> Fill aut applicatio�completely.
<br /> Owner 8 Contractor sign back of applicatior�,notarized(Or,copy of slgned contract with owner)
<br /> If nver$2500,a Noti�e of Commencement is requi2d(Mechanicai work over�5000)
<br /> Supply two(2)sets of drawings with applicable documentation
<br /> Aliow 10-14 days for r�view after submittal date. Parcel#-obtained from Property Tax NoUcs(http:/lappraisar.pascogov.com)
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