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813-780-0020 <br /> City of Zephyrhills Fire Fax-813-786-0021 <br /> Permit Application <br /> I�hon�Gartta�fi f�srP�rr�it z <br /> �te Received ,� <br /> ���.x��b� ����- l Z� ., G � <br /> . � �� S' OwneYs Phone Number �� <br /> vner's Name Z <br /> `_l '� i�(1- t �u.b . � !'� �i(.-�-� �C 3 � �`� <br /> vne�'s Address �" �� � <br /> Titieholder Phone.Number �] <br /> �e S�mple Til!eholder hlame <br /> se S�m�le?itlehoides Address <br /> ta;�eat'�RYlat�6'd14tMY�.'taCaA�lEt�' <br /> Lot# <br /> �b Address <br /> Parcel# <br /> �b Division <br /> ��,,�x�,. � <br /> � Bio-Hazard Wgste Storage-ANMUAL FumigBtion 7erYt <br /> � � Hazardous M�lteriai('�isr II ar RC!�acHiiy)+�NWU'�kL <br /> Comm Exhaust Kitcrien Hood/Duct � <br /> aControiled Burn Hood Installation <br /> � Q LP/N�twral C3as;instaliafion <br /> Emergency Generator<30 kw � <br /> � LP/Naturel Gss�lkNk�lLfl�L Sele <br /> Lmerga-cy CE^erafcr�3n kw � <br /> � Places af Assanil5ly-ANWUAL <br /> Fire ProYection Maintenance-IkNNUAL <br /> L��' +�m �. t sr � <br /> Sprinkler � f� 1� Gl ReGreStiCn91 Burn � <br /> Fire Alarm � ❑ � ❑ � � Sp�*iers ���� <br /> ood Cleantn � I�' O ❑ � � �Prinkler System Installations � <br /> � \ <br /> Ppression � ❑ � ❑ � � 5tandptpes(Sprit�kl�t Sy5) <br /> � Fire Alarm instailation � 7or�h RooflngRar K�itle <br /> Fire Pumps � Waste 1'ire Storage d�IVUAI <br /> � Fire Works <br /> Flemmable Application-AiJNUAL V21U8ftOt1 Of PI'Oj�Ct <br /> �� <br /> L_.! Fuel Tanks <br /> � Other: <br /> �,�aw.��, . '� — <br /> Compsrly fl d <br /> Contractor Registered 1'' N Fee Current Y <br /> Signature <br /> Address - G K Szj.T t�icense# <br /> ELEC7RIC4AN Gomp�ny <br /> Regtstered Y/W Fee Current ' 1'1 N <br /> Signature <br /> License# <br /> Address <br /> PLUMBER Compe�y <br /> Regfstered �i''I I�C Fee Gurrent Y/1'd , <br /> Signature <br /> License# <br /> Address <br /> MECHANICAL Company <br /> Registered Y.l,f!�I Fee Current �'�� <br /> Signature <br /> License# <br /> Adtlress <br /> OTHER Company <br /> Reg,stered Y/N Fee CuRent Y/.N <br /> Signature — <br /> Address ,.... rl�.,�. , � r,.�.,� , ,_.., . . ;o������ �s�s^;��uwro�..�,r, <br /> pk.u:i�mCgNi9R'QSI;!Po7+AdMFa}'FFFU..u, 2..f"' . . a. . , ax. ,I: .r �... . ,m, �t , .,. . <br /> Directions <br /> Fill out apGlication completely <br /> Owner&Contractor sign back of appiication,notarized(Or,copy of sYgnecf contract wlth owner) <br /> If over$2500,a Notice of Commencement is required(Mechanfcai work ovar$5000) <br /> Supply two(2)sets of drawings with appliceble documentation <br /> Allow?0-14 days for review after submittal date. Parcel#-obteined from Property Tax Notice(http:/lappralser.pascogov.com) <br />