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, s-a ;�c o02o City ofZephyrhills Fire FaX-a�s-��o-ooz� <br /> Permit Application <br /> Date fteceivc 7 � Phone Contact for Permit �/3 2y �7 7 <br /> C:�wners Name Q � Owner's Phone Number C� Ly7 77� <br /> Owner's Address �� (,� Py�S� P� � � <br /> Fee Simple 7itleholder Name �X Titleholder Phone Number �� ZT� 4�� <br /> Fee S�mpie l�±lehc'der Address u yV Q� .�y�, y �_ .r�/.r'1^7 <br /> ��d 4��`—.3.Z�J <br /> Job/`,�dress �Q�Z7. " • � <br /> Oo�ks rc.-l� h h,lls � 335�,1u �o,# �� <br /> Sub t)�vision Parcel# —� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> aControlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natura!Gas-ANNUAL Sale - <br /> C��Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � ` <br /> tr y emi �n t er / h <br /> Spnnkler f�Y� I-1 ❑ � a Recreational Burn /��) ��J�, <br /> ❑ [� ❑ � �`�t � <br /> Fire Alarm f 1 I ; I ! Sparklers <br /> Hood Cleaning � I I ] � , � ❑ Sprinkler System Instaliation <br /> Hood Suppression � I � � Standpipes�Spnnkler Sys) <br /> [__J� Fire Alarm Instaltation � Torch Roofing/Tar Kettle <br /> C � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL 'j,�(� Valuation of Project <br /> � Fuel Tanks <br /> � Other• <br /> Contractor Company F' w e •(,� <br /> Signature Registered Y/N Fee Current Y/N <br /> Address �(� �.y 5 ' License# <br /> FLEC�RICIA^J Company <br /> Signa?ure I Registered Y/N Fee Current Y/N <br /> Addres5 <br /> License# <br /> PLUMBER � Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address � <br /> License# <br /> �:)rFif f� Company <br /> ;igna�ure _ Registered Y/N Fee Current Y/N <br /> �ddres� [_ <br /> L�cense# <br /> ;�irecbons <br /> 1�li out apphcation completely <br /> ��o,^er 8 Contractor sign back of application. notarized(Or,copy of signed contract wrth owner) <br /> If over g�500,a NoLCe of Commencement is reqwred(Mecharncal work over$5000) <br /> Su;:�ply two(2)sets of drawings with apphcable documenta6on <br /> �Ilcw 10-14 days for rewew after submittal date Parcel#-obtained from Property Tax Nohce(http.//appra�ser pascogov com) <br />