|
813•780-002D Gty of Zephyrhills Fire Fax-813-780-002�
<br /> ' Permit Appiication
<br /> Date Rece�ved Phone Contact for Pertnit �il�1 9 y 2 ►9 9 3
<br /> � � —..__.._.. -- -- - - -�. �
<br /> _:�-+�,.::.--:�,.,-�------�..__.._��:��_.��__-•---..._._--:�_��_--�-�-;��: -=a,���--�=--��_-�:::�--w- - -- - _- - __---
<br /> ..,-._-.. ,_.,. _v,�.:_...:i _...�
<br /> - . .. _.
<br /> Owner�s Name �Z�L�p-S �L �//�(�- Owner's Phone Number b/3 7�� �J��
<br /> Owner's Address 3���� N� A�� Z��i�y���L S f L J�3S�D
<br /> Fee S�mpie Titleholder Name Trtleholder Phone Number � � �]
<br /> E 2d Simpie Titfehoitler AtldfCSs
<br /> � -- -- _.���;._.,__�_, ., ._9 _ �:�- -.�--: ���, - -�a-� -
<br /> --='=-r,-..-,..r_...�...._.....� ��t•eataT�vii�'��fi��o��3l.itiii i �1;�:r�=--:ir'�a.=:.._ ._
<br /> .. _....- _ -.r=.�wi'�i�.s::'43i�'�"`�' '_ _
<br /> JobAddress O ��O 3�• '��� �-l��LCS �L 335�o Lot# C�
<br /> Su�Diwsion P2fC21#
<br /> ._:._- -..___�... ..__.,u...- - - - - - =��-
<br /> .._�_ .._._�. .._ .�... . .... ,q;.�:�ssa�-"oT=.=�Si+wea+�=
<br /> .. --� . v��___-`
<br /> __ :._ _�_a...z��..a..�-._rr.-.'�i�i+TCY.�e?s'-�.:_"��'.�i'o�.__.....hv:f4:�Cr"=i +v.�'+..-�i.¢'.��� ______ "_ '
<br /> � Bio-Hazard Waste Storage-ANNUAL a Hazardous Materiel�er II or RQ Facility)ANNUAL
<br /> � Comm Exhaust Kitcher,NoodlDuct � Hood Installation
<br /> � Conuolied Bum .. � LPlNatura!Gas-Installation
<br /> � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Saie
<br /> � Emergen�y Generator:>30 kw a Places of Assembly-ANNUAL
<br /> aFire Protection Maintenance-ANNUAL � ReCrcational Bum � / �l
<br /> try emi �ln er � /�%L;/v
<br /> Sprinkler � ❑ ❑ p � � Sparklers �
<br /> Fire Alarm � ❑ ❑ � � � Sprinkler System Instailations
<br /> Hood Cleaning � ❑ ❑ p � � Startdpipes(Sprinkler Sys)
<br /> Hooc Suppression � Q ❑ p � � Torch Roofing/Tar Kettie
<br /> � Fire Alarrn Installation � Waste Tire Storage ANNUAL
<br /> nFire Pumps
<br /> �� Fire Wotks
<br /> QFlamrnable Application-ANNUAI. � Valuation of Project
<br /> fuel Tanks
<br /> � Other:
<br /> - _ , , .. _. ..._.: -
<br /> -_.._ _ _ . :_ _.�s: .
<br /> . _..�.--- _-,�=:-:_..__. �:�.
<br /> _. .s.�,�e�. . _�r.,..... _ .,, =������.,�. ��..�,�,�.,�..,,.��,.-,. - _
<br /> -— ��:.M;��-_.-
<br /> --—-- —�-,��� �_�:. -
<br /> contractor COmPany —j" � � ( �'1•o n
<br /> S�c�nature Registered Y!N Fee Current Y 1 N
<br /> �ddress 35 31 1�,¢ ,�ona Rd. ucense# �F 00 �11
<br /> i_LtCTRICIAN Company �—
<br /> �ignature
<br /> Registered Y/N Fee Current Y/N
<br /> a�idress License#
<br /> F'L'JMBGR Company —�
<br /> Signature Registerea Y/N Fee Current Y/N
<br /> 4dC ress t.icense# •
<br /> MECHANICAL COmpany
<br /> Sgnaturz Registered Y./N Fee Cum2nt Y/N
<br /> Address ����,
<br /> OTHER � CompBny
<br /> S�gnature Registered Y!N Fee Current Y/N
<br /> ACdress
<br /> - ____. _;r=...�___.�--.__.. � � - --
<br /> - -.._.,.,--_ _,._-_...__.>.—:.�:__=�--.a,= -,-- , ._ . _.._. __ _ _ _
<br /> �.... ._..._,.-_�: _-.-_-_.<..�:: _�f:;�...;�'�,�.� -`-�.- -�z._�<�
<br /> 6rcec'i ,�.._ llSe _ _ _ , - ---
<br /> �ons ---'- -.;._�.. _._� ..,�.�.___._ _._
<br /> F�u out applicaUon completely
<br /> Owner&Confrac2or sign back uf applicatipn,notarized(Or,copy of signed contract with owner)
<br /> If over S2500,a Notice of Commencement is required(MechaniCal work over g5000)
<br /> SuPP�Y 1wo(2)sets of drawings with applicable documentation
<br /> Allow 10-74 days for review after submitta!date. Parcei#-obtained from Property Tax Notice(http://appraisecpascogov.com)
<br />
|