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a�aaao-oo2o City of.Zephyrhills Fire FaX-a���so-oo2� <br /> � '' Pe it pplication <br /> Jate Received �� v��� �� Phone Contact for Permit ����I <br /> .. ,._-._,,..__.,-H..�_ ...,-. .. <br /> �s!�._-«.w....,._:«�i,�....:::.......Y...x...,,.....•....:.....:::��...._ .:�x:�.:>_.�r�:�.��st.�� ,,, "i / ✓ <br /> L:.. —1._ <br /> ���..+��;��-��.....:.._.__�_ - _ �..9 <br /> �wner's Name � �, 1��/� Owners Phone Number ,rJ�� j �/( J J ( <br /> gj � �] - _. <br /> �wner's Address ��, �Q1� ��j �,�/f P� G 3 3�7�,, <br /> =ee Simple Titleholder Name Titleholder Phone Number � C� � <br /> =ee Simple Titleholder Address <br /> -t,Y�.: _ .s...�,,..Y... <br /> " ' ''�"-fi °����.'"�;ZTi�i�''_.:��.�i`i���.:x.��.�'����-"�"n'°�°-'.'�a;-- .�-- _ - <br /> _.... =>.`�"�" <br /> ._.___�.,�.,.� <br /> c�a:��. �_� -- —��^'�-�--�.*�".��..r.."�'�.x-�.�:�:..—".,tsaP 1�?ras,a=,'}..��'�`t`�:Q'�'-?,�.�'.a'n-r-:_-• <br /> Job Address �-��1C����? �T�D ��C �J�,u�(!, Lot# C <br /> 5ub Division � Parcel# <br /> �.���.��.� _ �:::�u_ <br /> � Bio-Hazard Waste 5torage-ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum a Hood Installation <br /> aEmergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL <br /> ❑�y emi � er a <br /> Sprinkler O ❑ O RecreaGonal Bum � (� <br /> Fire Alarm � ❑ ❑ O �� � Sparklers l � r <br /> Hood Cleaning � ❑ � ❑ � a Sprinkler System Installations " <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn tnstallation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> aFire Works <br /> � Flammable Application-ANNUAL Vatuation of Project <br /> Fuel Tanks <br /> � Other: <br /> �� ---- ���- <br /> Contractor =���--��� ���� " <br /> ' Company � � �C�""R ��.�A <br /> 5ignature �L_ <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ELECTRICIAN <br /> Company <br /> Signature Registered �'/N Fee Curtent Y/N <br /> Address <br /> License# <br /> PLUMBER <br /> Company <br /> Signature Registered Y/N Fee Currenl Y/N <br /> Address <br /> License# <br /> MECHANICAL <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER <br /> Signature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> _ License# <br /> Directions: '"" ' ,.z <br /> �, �.�..�_ <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized(Or, copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical woric over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review afler submittal da[e. Parcel#-obtained from Property Tax Notice h J/a <br /> ( ttp ppraiser.pascogov,com) <br />