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, a��-�"aaoo2o City of Zephyrhills'Fire� Fax-s13-�80-0021 <br /> Permit Application <br /> late Received - Phone Contact for Permit rI y��-L—� r� <br /> :�3:5:�R!w':.�GL��F,-e.�„»,�.�,,...�.��oa.�w:uNw �"���"���t3��+�".�:.�r�+"�.,..«.�.�.�W....�� - - -''_r' <br /> hvners Nama G- �, C l � w �wne['s Phone Num6er [�ZL ,�J .L L.�_l Y�1.4.s�..L_ <br /> )wners Address e"'`�.1 � � S � � � � 33 S`'� � <br /> =ee Simpl=Titlehoider Name Titleholder Phone Number � C� � <br /> =ee SimpieTitleholderAddress <br /> s'�i'.°��.�''Y�e � �w��er�+��z:r.��w€ux�:��€���!,�i�� <br /> 1ab Address Lat# C <br /> 5u6Division ` �i-C. � Parcel# �� - �L -^ �� - r)1��C7 ' ��A 7l�0 "(�� �Q <br /> e.�t�'�GS$�� . , . r��"5�.`�o-��3f�slea�.E.'"�z+...��w:�ic:,z�:i,:.:�.�.�.:-'��.3"-� <br /> aBio-Hazard Wasie 5torage-ANNUAL � Fumigatlon Tant <br /> � Comm Exhaust f�tchen HoodlDuct � Hazardous Materiat(Tler li or RQ Faclliiy}ANHUAI. <br /> � Controlled Bum � Hood Instaliatlon <br /> � Emergency Generatar<30 kw � LP/Naturaf Gas-Installation <br /> Emetgency Generator>30 kw � LPlNatural Gas-ANMUAL 5ale <br /> Fire Protection Maintenance-ANNUAI a Places of Assembly-ANNUAL. <br /> �tF y emi � er <br /> Sprinkler � ❑ O O � Recreational Bum �2�/ <br /> Fire Alarm p ❑ }�i � � Sparklers � ��� / <br /> Hood Cleaning � O O '❑ � � Sprinkler System Installatlons <br /> Hood Suppression � O Q ❑ � � Standpipes(Sprinkler Sys) <br /> o Fire Alarm installation � Torcfi RaofinglTar KetUe <br /> Fire Pumps � Waste Tire 5torage ANNUAL. <br /> Fire Works • <br /> Flammabla Applicatlon-ANNUAL Valuation of Project <br /> Fuef Tanks <br /> Q Other: <br /> � � � ����:.� <br /> ConVactor Comparry ' ?.'� � .ir `� '�r�t - � }'►f.:, <br /> Stgnature L ' Registered Y N Fee Current N <br /> Address � �� � � �- C'' Licer►se# �� 1 i� <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address Ucense# � <br /> PLUMBER Company <br /> 5ignature Registered Y 1 N Fee Current Y/N <br /> Address Ucensa# � <br /> MECHANICAL Company <br /> Signature Registered Y J N Fee Current Y/N <br /> Address License# � �� <br /> OTHER Company <br /> 5ignature Registered Y/N Fee Cucreni Y 1 N <br /> Address License# r— <br /> a�a'�s'�=�-- - -- "dw.� - - v6F� �.., -=--.. � - �-..,..._ _ _s,n. -�.::=.es -,_: <br /> �irections: "'�"'��'�'"'�' <br /> Fill aut application completely. <br /> Owner�Contractor sign back ofi applicatiot�,notarized(Or,aapy of signed contract with ownsr) <br /> If over$250D,a Notice of Commencement is requited(Mechanica!work over 35000) , <br /> Supply Lwo(2)sets of drawings with appticable documentation <br /> Allow 10-14 days for revisw after su6mittal date. Parcel#-obtained irom Property Tax Notice(http:!/appraiser.pascogov.com) <br />