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s�s-�so-oozo ��'�5�. `' �ct 5'�'tE'�J"l�' <br /> City of Zephyrhills Fire ,- � Fax-als-7so-oo21 <br /> Permit Application ��'�1e-��f� �'��`�`E� rC ��aM ef� �VY <br /> Date Received . "" �- Phone Contact tor Permitv� Cf3/,y� ] � [�!.L:_LJ <br /> Owner's Name ��\ - Owner's Phune Number [413-413_381� �� <br /> Owner'sAddress rd ���(� � �1'�QCjt�_ <br /> Fee Simple Titleholder Name Titleholder Phone Number [_ _] � � <br /> Fee Simple Titleholder Address ---- <br /> Job Address 38130 Pretty Pond Road Tampa Florida 33634 Suite 114 = __, �ot# �� <br /> Sub Division Parcel# [ _ __ <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Mate�ial(Tier II or R(]Faci ity)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � �•' <br /> � Emergency Generator<30 kw LP/Natural Gas-Installation ���� �'��5 <br /> � Emergency Generator>30 kw � LP/Natural Gas-/1NNUAL Sale L <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUA,L Cr•��'F�� <br /> � tr y emi �n t er ❑ <br /> � � � � Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ �� � Sparklers / <br /> Hood Cleaning � ❑ ❑ � C� Sprinkler S stem Installations�,) � L � ��� <br /> Hood Suppression � Cl ❑ ❑ �� Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Stora�3e ANNUAI_ <br /> � Fire Works � <br /> � Flammable Application-ANNUAL �—_—, V�aluation of Project �p�a��� <br /> � Fuel Tanks ���� <br /> � Other� — -- <br /> — — � <br /> Contractor W __ Company y ' . <br /> Signature _ - �—�~ <br /> ' Registered Y/N Fee Current Y/N <br /> Address License# C _� <br /> ELECTRICIAN Company <br /> Signature Registered �Y/N Fee Curn�nt Y/N <br /> Address License# C—_ _� <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Curn;nf Y/N <br /> Address License# C _ _� <br /> MECHANICAL Company <br /> Signature Registered `(/N Fee Currc�nl Y/N <br /> Address License# C _ _� <br /> OTHER Company <br /> Signature Registered �Y/N Fee Current Y/N <br /> Address License# C � <br /> Directions: -- <br /> Fill out application completely <br /> Owner&Contractor sign back of apphcation,notarized(Or,copy of signed con ract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over g i000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date Parcel#-ob+�ined from Property Tax No'.ice htt //a <br /> ( p: ppr3iser.pascogov.com) <br />