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s�sasao�2o City of Zephyrhills Fire Fax-s��-�eo-oo2� <br /> • � Permit Application <br /> Date Received �— Pnaie Contact tor Pertnit ��'i 9 y� �q 4 3 <br /> ..... _... _ ..�__�-• _ . ,�_ ._�w,._:-,..-.:, <br /> ._.,,.u.:.—�—.�r„ ,—n rsa:.�w. �sAfF'�aw-���.._�FSi.�-.mc� . . .. __ _. <br /> Owner's Name NoR��vw�N D fi�'o�ER?y �16�/T, !lC pMrners phone Number � C� � <br /> Owner'sAddress �yoo SourH �'LE�E �0.00 ��03 y0����v�T"oN �/�Q l2 Z v� <br /> Fee Simple Titleholder Name Titleh0ldet Phone Numbet � � � <br /> Fee Simple TiUehottler Address _ y,., <br /> r. ..�" �..��n�a'.��'ry'�.`:��._'SahSGiOdIIYlE°i.:"suf3ilil..uwrtw�—�as-._ .....+r��. .='''1�'�YT'"+"+�-_:x:r.`�: . " <br /> JobAddress -- ° __C07 3� �E��C�i�� V�ELt/ �i✓. ZE��y/QIS//LL S �G .33S�Z lAt# � <br /> Sub Division P�� <br /> _ _._...._,_._.. .......-,__.�- . .�:�-°-���..,_��e�w;�:�. _ ---�...___:... . <br /> .._-:.-,..::��-�,.�� <br /> .. . . ,, .�,--�}:;.N._:,: <br /> � ' Bio-Hazard Waste Smrage-ANNUAL a Hazardous Material(Tier 11 or RQ Faality)ANNUAL <br /> � Comm F�d�aust K�tcheo HoodlDuct � Hood InstallaUon <br /> � Corrirolled Bum � LPMatural Gaslnsfallation <br /> � Emergency Generator<3p� a LPlNatural Gas,IWNUAL Sale <br /> � Emergency Generator>30 kw a Places of Assembly,A1VNUAL <br /> DFire Protection MaiMertancx.ANNUAL � Recreatbnal Bum <br /> � emi � r <br /> ���� o 0 0 0 ❑ ��� 5--�/.� <br /> Fire AWmt � ❑ ❑ 8� � � Sprinkler Syst6m Inctallations �l <br /> Hood Cleaning � ❑ ❑ O � Stsndpipes(Sprinkler Sys) <br /> Hood Suppressan � �� ❑ ❑ � Torch Roofing/Tar Kettle <br /> � Fire Alarm Insiatlation � Waste Tire Storage ANNUAL <br /> Fue Pumps <br /> fire Wrorks <br /> Fiammawe n�r�aior,•n�ua. � Valuation of Project <br /> Fuel Tanks <br /> � Other. <br /> _. t,..... „�:.. ..w; _.. ..�-- _ , � � <br /> - ,_...,_...:_-`�...l,:'�s....:��- -�.��r�:�t�-,�:,.��a=:�. .r_. , <br /> Conuador CAmpany T � � 'O <br /> Signature Ragi�ered Y%N Fee Current Y!N <br /> nddress 3 5 31 1�e ��+an t a1. license# T` O N t <br /> ELECTRICIAN COmpany <br /> signature Regi.stered Y/N Fee Curcent Y/N <br /> Address License# <br /> PL'JMBER ComPa�Y <br /> S�gnature Re9istered Y/N Fee Current Y/N <br /> Address Licen58# <br /> MECHANICAL Compeny <br /> Signature Registered Y/N Fee Currant Y/N <br /> Address License� <br /> OTHER Compeny <br /> Si9nature Registered Y/N Fee Current Y/N <br /> Address lkens��t <br /> ,.. _._._ ... _ _ ,_.:_; �._.... _ -•_- -- �.- E..3--- - -�-, - <br /> :,:._,.�_r_.� . . -:�..-�_�,-�:�. ,�:- - - - -�..-. .. -_..---_ ___. _.. <br /> Directions: - <br /> Fi1l out application completdy. • <br /> Ownet 8 ConMacOOr sign bedc of aPW�catbn,nofarized(Or.copy of signed contract with ownet) <br /> If over 52500,a Notice of Commencement is required(Mechanical work over 56000) <br /> Supply two(2)sets of drawin9s with aPpliCebb documenia�on <br /> AIIOw 10.14 days tor teview atter submittal date. Parcel#-obtained from Propsrty Tax Notice(http://appraiser.pascogov.com) <br />