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813-780-OG20 City of Zephyrhills Fire FaX-s;a-�ao-ooz�
<br /> , Permit Application
<br /> Dat=Received � —�
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<br /> e Contact for P
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<br /> Owner's Name A�� L �f�N (�V5 T•���V��N r�� er's Phon=Number
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<br /> Owner's Address . D �}y'�1�{3 a P " � —�cl A L � 3. � — ! / (
<br /> ree Simolz Titleho(der Name Titleholder Phone Number C� � �
<br /> Fe=Simple?itleholder Address
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<br /> Job Address \a �� � V Lot t �
<br /> SubDivision Parcel,= D3 - �co- �l -oc�io _�a�� _o�od
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<br /> � Bio-Hazard Waste Storage-ANNUAL � Fumioation Tent d '
<br /> � Cornm Exhaust Ki'tchen HoodlDuct � Hazardous Material(Tier II or RQ racility}ANNUAL
<br /> � Controlled Bum � Hood Installation
<br /> � cmergency Generetor<30 kw � LP/Natural Gas-Installafion
<br /> � Emeroency Generetor>30 kw � LP/Naturel Gas-ANNUAL Sale
<br /> `-�- Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
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<br /> Sprinkier � ❑ ❑ � � � Recreafional Bum ! v
<br /> Fire Alarm � p ❑ ❑ � � Sparklers j���
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<br /> Hood Cleaning � � ❑ u � � Sprinkler 5ystem installations
<br /> Hood Suppression � ❑ ❑ n �� � Standpipes(Sprinkler Sys)
<br /> � Fire Alartn tnstallation � Torch RoofinglTar Kettle
<br /> � Fire Pumps � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> a Flammable Appiication-ANNUAL Valuation of Project
<br /> � Fuel Tanks
<br /> � Other:
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<br /> Contrector
<br /> Company —�
<br /> Signature Registered Y/N ree Current Y/N
<br /> Address
<br /> License#
<br /> ELECTRICIAN Company
<br /> 5igraiure Registered Y/N Fee Current Y/N
<br /> Address
<br /> License�
<br /> PLUMBER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address
<br /> Licensz�
<br /> McCHANICAL
<br /> Company
<br /> Signature Registered Y/N Fee Curren? Y/N
<br /> Addr=ss
<br /> License�
<br /> OTHEP, . Company = — �/�2O
<br /> Signature Registered Y/N Fes Current N z
<br /> Address
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<br /> �cense ,
<br /> Directions' - - — .:..... .... �.- _.., _...__..x.�.x_�......,.,_�.. ...... ......�_._.,_..__.,.-.... . .-- ,
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<br /> Fill out applicaiion completely
<br /> Owner&Contrector sign back oi application,notarized(Or,copy of signed contract with owner)
<br /> I�over 52500,z Notice o•`Commencement is required(Mechan�cal work over W5000)
<br /> Supply two(2)s=ts of drewings with applicabl=documentation
<br /> Allow 1 G-14 days 1or revi=w after submittal date Parcel r-obtained trom Properiy Tax Notice(http.happreiser.pascogov.com)
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