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813-780-0020 <br /> . • ` City of Zephyrhills Fire <br /> Permit Application Fax•813-780-0021 <br /> Date Received �—� <br /> ;.:. Phone Contact for Permit }�� 9 y z �q�3 <br /> : -:::. , . ,_: <br /> ,;,, �, , <br /> Owner's Name C/¢�LI�l�(/'f �. //e d <br /> �_r ��� Owner's Phone Nurnber � � � <br /> Owner's Address 3 8y��b �iN�,'� 2 Z�j S �!/ ��, �� <br /> f C� <br /> Fee Simpie Titleholder Nan�e �� � ���------------------��---��� <br /> Fee Simple Titieholder Address Titleholder Phone Number � j <br /> _ u <br /> ,- ,�. . . _ . <br /> : _: F ,::- : <br /> 3�aa� . = ,_ . _ <br /> JobAddress ���� � >n �_/�//�� � <br /> �V/[i K, L 7�T ` � <br /> Sub Division Lot# <br /> ,;; _ Parcel# i <br /> � : < - ,:: _ _ <br /> Bio-Hazard Waste Storage-ANNUAL � � ` <br /> � Hazardous Material(T�er!I or RQ racility)qNNUAL <br /> Comm Exhaust Kitchen Hood/Duct � <br /> � Hood Instaliation <br /> Controlled Burn a <br /> � Emergency Generator<30 kw �P�Natural Gas-Instailation <br /> � � LP/Natural Gas-ANNUAL Sale <br /> Emergency Generator>30 kw � <br /> � Fire Protection Maintenance-ANNUAL Places ofAssem6ly-qNnlUAL <br /> try emi � � Recreational Burn r <br /> er � �� <br /> Sprinkler � � � � ❑ /�� � <br /> Sparklers ' <br /> Fire Alarm � � � � ❑ <br /> ❑ Sprinkler System Installations <br /> Hood Cleaning � C � � ❑ e__ <br /> ❑ Standpipes(Sprink�er Sys) <br /> Hood Suppression p � � � ❑ <br /> � Torch Roofing/Tar Kettle <br /> Fire Alarm installation � <br /> � Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> � Fire Works <br /> � Flammable Application-ANNUAL <br /> � Fuel Tanks Vaivation of Project <br /> QOther: <br /> .. <br /> _ <br /> ., ,. <br /> on rac±or ' � _.: ,; _. <br /> .,:: <br /> _ , <br /> - _ . .. � <br /> Signature Company -T-- � + <br /> �aaress 3gg r �� Registered Y/N Fee Current Y/N <br /> �on <br /> E�ECTRiCIAN License# Q 3 � 1� z <br /> Signature Company <br /> Address Registered Y/N Fee Current Y/N <br /> P l UM B E R License# � <br /> Signature Company <br /> Address Registered Y/P; Fee Curr2nt �'/� <br /> MECHANICAL License# � <br /> S�gnature Company <br /> Address Registered Y/N Fee Current <br /> Y/N <br /> vTHER � License# � <br /> � <br />=igratur� Company <br /> Address � Registered Y/N Fee Current Y/N <br /> Cirec:ions. ' " _ , . <:. _ _ License# � <br /> : _,:::: _ <br /> Fill out application completely. ` <br /> Owner&COntractor sign back of application,notarized(Or,copy oi signetl contract with owner) <br /> tf over$2500,a NotiCe of Commencement is required(Mechanicai work over$5000; <br /> Supply two(2)sets ot drawings with applicable documentation <br /> Ailow 10-14 days for review after submittal date. <br /> Parcel#-obtained from Property Tax Notice(http�/lappraiser.pascogov.com) <br />