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� 813-760-OQ20 Ciry of Zephyrhills Fire fa�c-szsaso-oazl <br /> � � Fermit Applicatian <br /> Date Raceived �ir� i tI— i�-{ � � Ph�e Contac:t tor Fermit Qs1'�'i �J'�J� t9 <br /> .�,,�,��� en . �-:��. ���-.,�,,• <br /> Owsror'a Narna ;�'P� �'f!�`� 1.. r.� h�- Owner's Phane Numbar �s�"x '7+�,Z 1'.Z.ZZ. <br /> owr,�rsnad�oss L�;ht� t'd '���D. ZeP� � �i1.�r FLatz.ir�� <br /> Fee Simple Titlehoider Nar� � � i 7itlehoider Pho�e Number � �_:� �� <br /> FCe Sim�e Tidahddar Address � i <br /> dob Address U�C!�"'I Ct A L.�-- � �P. � � R.1 DA Lot# C� <br /> Sub Qivisiat A PBtcel# � <br /> :�+�z,�:�;.v . 5:.,���::�a:a�r:sa�= �.:::�.'�a-�'�+:���* ^�r,��::sa�€-,e`�s*M���:.c.��°�-�, _ <br /> a Bio-Hazard Waste Storape-ANNUAL Q Fumigation Terd <br /> � Comm Exhaust Kitchen Hood/Duct Q Hazardous Material(Tier II or RQ Fadliry)ANNUAL <br /> � Contrdled Bum Q Hood InstallaGon <br /> � Emerpency(3enerator<30 kw LPM�tural Gas-Installation <br /> � Emergency Generetor>30 kw � LP/Neturai Gas-ANNUAL Sate <br /> � Fira Protedion Maintenance-ANNUAL Q Piaces oi Assembiy-ANNUAL /� <br /> � �� � � (�R (.Y <br /> Sprinkier � ❑ Q ❑ � � Rerxeatipnal8um � j S 7 V 7 <br /> r <br /> Fire Alsrm � ❑ C! !� � � Sparkiers � <br /> Nood Ctesning � II L7 O � Sprinkler System InstaNations <br /> Haxi Supprassion � ❑ O ❑ �___� � 3tandpipes{Sprinkier Sys) <br /> QFiro Afarm insta{iation � Torch Raafingtfar Kettia <br /> Fire Pumps Q Waste Tire Storage ANNURL <br /> fire Works <br /> Flammabie Rppiicatior'�-ANNUAL i r��e.�jp�—'" � VSIt,18litNt pf PfOJBCt <br /> Fuel Tanks � <br /> ❑ t�'t@f: Z- I <br /> � <br /> Cantractor Company <br /> signakure Registered Y!Pt Fee Current Y t N <br /> Address � License# <br /> ELECTRICIAN Company <br /> sipnature Repistered Y J t�l F�Current Y 1 N <br /> Address �icense� <br /> PLUMBER Company <br /> signature Reglsterod Y J N Fee cument Y!N <br /> Address Ucense# <br /> MECMANICAI. Comparry <br /> Signature Repistered Y!N Fea Current Y 1 N <br /> l4ddress License# <br /> 07HER Company {1 V TI C, XL <br /> Signature Registered Y 1 N Fes cumgrn Y!hl <br /> Address 7it 1/"� Tl4 • License# <br /> ��• _ . .,�--::����°�o <br /> Dinections: <br /> Fiii out appiication cvmpletety <br /> Owr�er&Cantredar aign baek o!appdcatian,notarized{pr,copy of sigried contrect with owner) <br /> If over 5250Q,a Notice of CommencemeM is required(Mechanical work aver�5000) <br /> Suppiy two(2}sets af drawfnga wiN�appiicabie documerftation <br /> ,4llow 10-14 days for revicw afRer submfttal date, Parqel#•csDtained from Property Tax Notice{http:l/appraiser.pasooQov.com) <br /> �. <br />