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<br /> City of Zephyrhills Fire
<br /> ;i Permit Application Fax-813-780-0021
<br /> Date Received I�
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<br /> Owner's Phone Number �� z,3 y + ZZ G
<br /> Owner'sAddress "'] ' �'�eQ��� �
<br /> Fee`Simple Titleholder Name ;, � � �
<br /> Fee Simple Titleholder Address Titleholder Phone Number
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<br /> Job Address 0.�) '�/M "�"N ���s,car�.�xu,..xe . .-aw,.:,.,rr;:,;:.s���..�.,.,
<br /> Sub Division Lot� �
<br /> .. ._ . . __° ..., �,.._.._ I= Parcel# �Q'Z,�n Z)" 00
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<br /> -Hazard Wa e Storage-ANNUAL `�''T� '� ""� •"':"""� -
<br /> � ! � Fumigation Tent
<br /> Comm Exhaust �itchen Hood/Duct � Ha-<ardous Material(Tier II or RQ Facility)ANNUAL
<br /> � Controlled Burn I �
<br /> � Hood Installation
<br /> Emergency Ge e�rator<30 kw �
<br /> � I LPlNatural Gas-Installation
<br /> Emergency Ge �rator>30 kw �
<br /> � � LP/Natural Gas-ANNUAL Sale
<br /> Fire Protection aintenance-ANNUAL �
<br /> i Places of Assem61y-ANNUAL
<br /> �y emi � er �
<br /> Sprinkler j � � � �
<br /> ❑ Recreational Bum
<br /> Fire Alarm i � � � (�'�� �
<br /> ❑ L Sparklers
<br /> Hood Cleaning � � � � �
<br /> ❑ Sprinkler System installations
<br /> Hoad Suppress �n � � � �
<br /> � ' Standpipes(Sprinkler Sys)
<br /> Fire Alarm Insta),�ation �
<br /> �"—"} � Torch Rooftng/Tar Kettle
<br /> �� Fire Pumps
<br /> Waste Tire Storage ANNUAL
<br /> j��� Fire Works I
<br /> � Flammable App iFation-ANNUAL
<br /> a ' Valuation of Project
<br /> Fuel Tanks �
<br /> QOther: i
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<br /> Signature i Company
<br /> Address �
<br /> Registered Y/(�l Fee Current Y/N
<br /> � ' License# �'I =r
<br /> EL�CTRICIAN � I
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<br /> Signature Company �
<br /> Re9istered Y/N Fee Current �/�—
<br /> Address
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<br /> License#
<br /> PLUMBER �
<br /> Signature i Company --�
<br /> Address Registared Y/N Fee Current Y/N
<br /> MECHANICAL ' License# �— �`�"�'�
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<br /> Signature Company —'— �
<br /> � R�gistered Y/(�J Fee Current Y/N
<br /> Addrass
<br /> License#
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<br /> Signature Company �— �
<br /> Registered � r i iv � Fee Current Y/N�
<br /> Address , �
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<br /> Owner&Contractor sig �6ack of application,noterized(Gr,copy of signed contract with owner)
<br /> If over$2500,a Notice f Commencement is requirad(Mechanical work over$5000)
<br /> S�aPP�y�o(2)sets of d awings with applicabla documantation
<br /> Allow 10-14 days for re iew after submittal date narcel#� oEtained f;om Property Ta�Notica(irttpJ/appraiser.pascogov.com)
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