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� 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021
<br /> Permif Applicatian
<br /> �te Rece�ved Whoti�Gbntatl PerPerririt j 3 Z .' / �� C f
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<br /> vner's Name �"� ' �S OwnePs Phone Number � Z Zt�G` v
<br /> vner's Address G' � C� ��� `l��-J
<br /> �o Slmpie Titlehoider hlame Titleholder Phane-Number �� �„� �
<br /> ;e S�mple Titieholder Atldress
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<br /> >b Address G � C:, A � � [ C U� . �� (r"/'�t 2lt/�G„S ��. .3� 3�'�v Ldt#
<br /> Wb Division Parcei#
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<br /> � Bio-Hazard Waste Storage-ANFIUAL Q Fumigation 7st9t
<br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous kA9'teHgl(Tfer II or RQ°FacNity)�1N�IU�4L
<br /> � Controiled Bum � Hood Instalfation
<br /> � Emergency Generator�30 kw Q LP/Natural C3asa{n�tallation
<br /> � Emergency Geners:cr�30�:w � t.P/Natur�l GasW1KNNU�L 9aie
<br /> � Fire Protection Mainten�nce-�N�IUAL � Places of Assenibl��JINhIUi1L
<br /> ��] �m � �r �p�
<br /> Sprinkler � Cl ❑ ❑ � ReGr'eStiCnglBum � (�
<br /> Fire Alarm � ❑ � ❑ � � Spfirklars
<br /> Hood Cieaning �C, ❑ C� O � ]Z/i'� Sprfnkler System Instailations
<br /> Waod Suppression � ❑ � O � 3tandpfpss(Sprir(I�I�r Sys)
<br /> � Fire Alarm instailation � 7oreh f2oofing/tar ICe�kle
<br /> n Fire Pumps � Waste tire Storage AWNUAL
<br /> ��r Fire Works
<br /> � Flammabte Appiication-ANNUAL Valuation of Project
<br /> Fuel Tanks
<br /> � Other:
<br /> �.,�.�xT�;vr;a���a� .
<br /> Contractor � � Comparty c:� �
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<br /> Signature ' � Registered N Fee Current Y/
<br /> Address ��� " C ' ' S License#
<br /> ELECTRICIAN Ccmpany
<br /> 5lgnature Registered Y/M Fee Current Y/fV
<br /> Address License#
<br /> PLUMBER Comparty
<br /> S�gnature Registered �'.�1'W, Fee Cw[rent Y/trl
<br /> Address License#
<br /> MECHANICAL Company
<br /> Signature Registered Y/.Id Fee Curcent Y/N
<br /> Address License#
<br /> OTHER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
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<br /> i ., ,�.�r_n :,yHm;,a Mr.�.,,mu�,,,u.unr.��-,;�r ,n.e�..ai.,.e,.., .. .. '-a�MT�' �P'.,nd,m . �.W� RM��
<br /> Directio�s
<br /> Fil!out application completely
<br /> Owner&Co�tr2ctor sign back of application,notarized(Or,copy of signetl contract wlth owner)
<br /> If ader$2500,a Nolice of Commencement is required(Meohanical work over$5000)
<br /> Supply two(2)sets of drawings with appliceble documentation
<br /> AUow?0-14 days for review after submittal date. Parcei#-obtained from Property tax hfotice(http:/lappreiser.pascogov.com)
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