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si�-3 ao-oo2o City of Zephyrhills�Fire� Fax-813-780-�D21 <br /> � Permit Application <br /> Phone Contactfor Permit •�;��� <br /> late Received ^� �� _ ;�+x�� y-R--� �-° �°�-� <br /> :�:.s:v��::��a��,-p._..,.�....�,.�.��m. • LS2.L_.�-� LJ/d �( I ��1!�L <br /> huners Name N1 f Owner'S Phone Number <br /> ` ' -� �� � <br /> )wne�s Address � � <br /> =ee Simple TiUehoide+ Name TiHeholder Phone Number <br /> =ee Simple7itlehoiderAddress ��q��,�_�„a�s <br /> �''a,.'-,�(ii.m�� � � <br /> �.Ot�i <br /> Job Addr=ss <br /> Sub Division � Q � �1 Paroet# <br /> a�'s�'s�'.�;:m,F�a*.�°.s�6,���:��.:::_,��vs�-�.:-.:_.��*� <br /> �._-.���"�,�� � _ . <br /> a BiaHazard Wasie 5tatage-ANNUAL � Fumigatlon Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Matedal(7lar li or RQ Facilify)ANNUAL <br /> � ConUofled Bum a Hood Instailation <br /> � Emergency Cenarator<30 kw � LP/Naturaf Gas-Installation <br /> Emergency Generator>3D kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Mairtenance-ANNUAL a Places of Assembly-ANNUAL <br /> � emi � er <br /> Sprinkler � ❑ ❑ � Reereational Bum � � ��� , / <br /> � ❑ N <br /> Fre Alamt � ❑ ❑ � 5parklers <br /> Hood Cleaning ❑ O ❑ � a Sprinkler Systsm Installatlons <br /> Hood Suppression � O ❑ O � a Standpipes(SprinWer 5ys) <br /> Q Fire Alarm Instaliation � Torcfi.Raofing(iar Kettle <br /> Fire Pumps � Waste Tire 5torage ANNUAL <br /> Fire Works ' <br /> Fiammable Applicatlon-ANNUAL Valuation of Project <br /> Fue(Tanks <br /> � Other: <br /> ���s�� <br /> 'Contractor Comparry ' � •,. � �� •� � '�r� • .� t°• <br /> Signature ' Registereil Y N Fee Curtent I� <br /> Address � 1 - � ' t""' Licer�se# J t'', i i3 <br /> ELECTRICIAN Company <br /> 5lgnature Registered Y I N Fes Current Y 1 N <br /> Addres° llcense# <br /> PLUMBER Company _ <br /> Signature Reglstered Y/�1 Fee Gurrent �(/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y I N Fee Curre�t Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y 1 N <br /> Address License# <br /> ;����na'�a�ir�--._.... ...,.,. .�.. --= <br />