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s��-7ao-ao2o City of Zephyrhills'Fire� Fax-813aso-oo2� <br /> Permit Application <br /> )ate Received Phone Contact for Permit ���T� <br /> :-�v.'.5:��'TCR.�;i1SC+..dF�n`ffi�.o-�. .r-waaa . , � r �.c.....a..ca.......� - ... .. - .. ....__... <br /> Tn�ners Name � Owner'S Phone Num6er �� �� <br /> �wnersAddress � y � l.T"��� �� �-e- ` S I .3�5 �" <br /> =ee Simple Tiileholder Name Heholder Phona Number �� � � <br /> =ee SimpleTitlaholderAddress <br /> ��.�Tfs��.� - �':������'�1•�=?:" ,x�a� '::u <br /> Job Address L �T�.�,� �` U � � �+ � � 35 ot# � <br /> SubDivision � '� � Parcei# � �S ' � ' ���� 'U/��� <br /> ,�.=,g.,�� �s��:wti�=ass�n�a:��,;.r <br /> J�`��"`� <br /> a Bio-Hazard Wasie 5torage-ANNIlAL � Fumigatlon Tent <br /> � Comm Exhaust Iatchen HoodlDuct � HazaMous Matedal(71er li or RQ Facility)ANNUAL <br /> � Controlled 8um � Hood Instatlatlon <br /> � Ec:,ergency Generator<3Q kw � LP1Natural Gas-Installation <br /> Emergency Generator>30 kw � LP1Natural Gas-ANNUAL 5ale <br /> Fbre Proteodon Mairttenance-ANNUAL � Places of Assembly-ANNUAL <br /> �y emi A�n er � , / � //�/(j <br /> Sprinkler � ❑ O O � � Recreatlonal Bum (�f� �� �t ��� <br /> Fire Alarm � ❑ ❑ � �� � Sparklers <br /> Hood Cleaning ❑ ❑ ❑ � a Sprinkler System Installations <br /> iiood Suppression � ❑ � ❑ C� a Standpipes(Sprinkler Sys) <br /> � Flre Alarm Instaliafion � Torcfi Roofing(far KetUe <br /> Fire Pumps � Waste Tfre 5torage ANNUAL <br /> Fire Works • <br /> Flammable Application-ANNUAL Valuation of Project <br /> Fuef Tanks <br /> � Other: <br /> ���,��,�:�,�: P, ����:.=� <br /> ConVactor . Comparry " > -,� n.i. ` 'ir� = "'/11e, <br /> Signature ' Registered Y N Fee Current N <br /> Address � 1 c � _ ' � � �"' Licer►se# ��, i i� <br /> ELECTRICIAN Compeny <br /> 5lgnature Registered Y/N Fes Current Y/N <br /> Address Uaense# <br /> PLUMBER Company <br /> 5ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Ragistered Y/N Fee Current Y/N <br /> Address License# <br /> O7HER Company <br /> 5ignature Registered Y/N Fee Current Y/N <br /> Address LiCense# <br /> 'Y,.'.G�'a�___�.... �. ac-�-._...,.. sm�..a.+n++.am.ara+rwu....,...�....,..���__'�.��.'_=._s...� . J.._ ��..zaxu�-��:__,�...czr�'¢PF'�'r.u:IZ'1� <br /> Directions: '"'°°`—�' <br /> Ftl aut applicalion completely. <br /> Owner 8�Contractor sign back of application,notarized(Or,copy of slgnad contrect with owner) <br /> If over 52500,a No6ce af Commencement is required(Mechanical work over 35000) , <br /> Supply two(2)sets of drawings with appiicable documentation <br /> Allow 10-14 days for review after submittaV date. Parcel#-obtained from Property Tax NoU�e(http://appraiser.pascogov.oam) <br />