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a�s-�eo-oo2o City of Zephyrhills Fire Fax-813-780-0021 <br /> Permit.Application <br /> Date Received4 Y, ��,{`.„`Z. w_Zt�(�� 4�`�w"�V.�'� ..'0.._4V ` µ,�'. ' ' .Phone Contact for Permit_.t=�r Q�Q.(o ,; ,�_._�".__,� <br /> ' . - - __ .r.._._._._ -�-.- <br /> Owner's Name �D�jO 1 I � 0.�i On Owner's Phone Number g�3 3yZ m� 36 gG <br /> Owners Address �3Z� lTQ-C� ���� <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> L=..�.»�._v.....,..ae,... ^�.i'._.."'..- _ ' .�._ _.L� -�t <br /> Job Address ��fl"�� .Lot# �J� <br /> Sub Division Parcel# <br /> � ���� � Bio-HazardWasteStorage-ANNUAL�W���P��'��. ��VFumigationTent �� T�M_��.�._a,..._�..�,�_..�.,m�_�d. <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL � Places of Assembiy-ANNUAL � <br /> t y emi �n t er ���q� 5�/7 <br /> �;�1 %�.�- <br /> i Sprinkler � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � . � Sparklers � <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ � � � - � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> I � Fire Works <br /> Flammable Application-ANNUAL V81U8t10f1 Of P�O 2Ct <br /> ❑ � <br /> � Fuel Tanks <br /> Q Other: <br /> �..—�_����_,_,..e.__r�._..._,...__�.� �,�.._..,....�_�.�.,_��..�.._._..__ _..-��,�...��� �..��...--�����.._.�,.._._.�_,_.��.�._.�,..�,_�___._�:,�_.�.�___ ��. <br /> Contractor Company ��c r� I�-�-4� r�� <br /> Signature Registered Y/N Fee Current Y/N <br /> Address Q p �j � 0` 3 ?jQ License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> SignaWre Registered Y/N Fee Current Y/N <br /> Address License# <br />, MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> - _ ..�._�...�_,Y......._...__���._°___...._,.Y,_.. __..._��_�,a..�__�a._,..�____.�-.,_...-_�.��-�_�__.. wz._...___a,_�.,.�-�_.__.a..�._�._.,-..._.,._..�__ a.w�>.._.,,.�..-.-.=- --=� <br /> Directions: w <br /> Fill out application completely. <br /> Owner 8�Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />