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s��-7�a-oa2o City of Zephyrhills�Fire� <br /> Fax-813-780-Q021 <br /> Permit Application <br /> late Received - Phone Contactfor Permit ���:��� <br /> :�:s:��R!�w�a:�,-e_.„W...�.+....,�..��� ����+�-- �+,s�^,u,��"..,..�,.,�.��.._..�_.,.,�.......�._..___�_ <br /> }wners Name �S , ,r Ovmer's Phone Num6er �,3 � �S <br /> �wner's Address G� 1 � <br /> 'ee Simple Titleholdei Name TiHeholder Phone Number �� � <br /> =ee SimpleTitlahoiderAddress <br /> a i�..,7F� "��E�1D�a�f�.�!� <br /> Job Address Lot# <br /> Sub Division � -E?. Q ' Parcel# �o� '�(p'a/ 'L�UI v -G��/QO -LL'7�d <br /> c.ers�.N�cP_w+� f'$'I6�ik�cak+^��F'�°bm�ij.i—c;!«'�C:EaL°i<in'�°.�-"-:�=.-.Y�s�:..��*"S.Y <br /> �a Sio-Hazard Waste 5torage-ANNUAL � Fumigatlon Tent <br /> � Comm Exhaust FGtchen HoodlDuct � Hazardous Material(71er li or RQ Facilify)ANNUAL <br /> � ConVolled Bum a Haod Installatlon <br /> � Emergency Generator<30 kw � LPJNatural Gas-InstallaBon / <br /> Emergency Genarator>30 kw � LP1Natural Gas-ANNUAL Sale /j�'"J <br /> �l �/ <br /> Fire Protection Mai�tenance-ANNUAL � Place5 of ASSembly-ANNUAL � l cJ <br /> �y ami � ar <br /> 5prinkler � ❑ O ❑ � a RecreaUonal Bum <br /> Fire Alartn � ❑ ❑ � � � Sparklers <br /> Hood Cleaning O O � C� � SprinklerSystem Installatlons <br /> Hood Suppression � O Q � � � Standpipes(Sprinkler 5ys) <br /> QFire Alartn Insiailation � Torch Raofi�gfTar Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works ' <br /> Flammabla Appl(catlon-ANNUAL r Valuation of Project <br /> Fusf Tanks <br /> � Other: <br /> � _ °��� <br /> ConVaotvr ^ Comparry � ? ', �' n.+� r '�r�t t-, <br /> Sfgnature ' Registerad Y N Fee Curtent N� <br /> Address � 1 � � �' �'" License# �+; i v <br /> ELECTRICIAN Company �— <br /> 5lgnature Registered Y 1 N Fee Current Y/N �� <br /> Address License# <br /> PLUMBER Company <br /> 5ignature Registered �(/�f Fee Curtent �(/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y 1 N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Ragistered Y/N Fee Current Y/N <br /> Address LiCense# <br /> ;�;a�r--"....-_ - -�...-,��:m.�.�,� -,�....:�n�n� ----� . w..._,_,_�-_,.�_>,:e_��rr�`u:!e: <br /> DirecGons: <br /> Fill aut application completely. <br /> Owner&Contractor sign back of appli�ation,notarized(Or,copy of signad contract with ownsr) <br /> If nver S250D,a NoBoe of Commencement fs required(Mecnanica!work over 550D0) . <br /> Suppiy two(2)sets of drawings with applicable dacumentation <br /> Allow 10-14 days for review after submittal date. Parcel#-abtained from Property Tax Notlee(http:/lappraiser.pascogov.com) <br />