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a�s-7so-oo2o City of Zephyrhills Fire Fax-a�3aso-oo2�
<br /> Permit Application
<br /> 4ate Recei.ved � �^ � I Phone Contact for Permit
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<br /> wner's Name ! 2 /� � Owner's Phona Number )' �p �j �d ��
<br /> wne�s Address ( j�� � � /'!'t �IJ ���7
<br /> Fee Simple Titleholder Name � Titlehalder Phone Number �� �� �
<br /> Fee Simple Titleholder Address �
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<br /> Job Address �� ��� 'Lot# �
<br /> Sub Divisivn Parcei#
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<br /> �� �Bio-Hazard Waste Storage-ANNUAI. � � � Fumigation Tent N
<br /> � Comm Exhaust Kitchen HoodlDuct � � Hazardous Material(Tier II or RQ Facility)ANNUAL
<br /> � Controlled Bum I � Hood Installation
<br /> � Emergency Generatar<34 kw � � LPlNatural Gas-Installation
<br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale
<br /> o Fire Pratection Maintenance-ANNUAL � Places of Assembly-ANNUAL�Q ��j����'��
<br /> t y emi � t er l
<br /> Sprinkler � ❑ ❑ ❑ � � Recreatianal Burn
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers .
<br /> Hoad Cleaning � O � ❑ � � Sprinkler System Installations � /�!\�
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<br /> Haod Sugpression � CJ ❑ 0 � � Standpipes(Sprinkler 5ys) I _���
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<br /> QFire Atarm instaifaUon � � Torch RoofinglTar Kettle 1\,J
<br /> � Fire Pumps � � Waste Tire Storage ANNUAL
<br /> � Fire Works
<br /> � Flammable Application-ANNUAL I ��� Valuation of Project
<br /> oFue!Tanks �
<br /> Q OEher: I
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<br /> ontractor � I Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address � License#
<br /> ELECTRIClAN Company
<br /> Signature Registered Y I iV Fee Current Y/N
<br /> Address � License#
<br /> PtUtu48ER � Company
<br /> Signature � Registered Y/N Fee Current Y/N
<br /> Address � License#
<br /> MECNANiCA� I Cornpany
<br /> 8ignature Registered Y/N Fee Current Y/N
<br /> Address ; License#
<br /> OTHER I Gompany
<br /> Signature � Registered Y!N Fee Current Y/N
<br /> Address j license#
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<br /> Direations:� � . .. I .
<br /> �iil out appticatiar�camptetely.
<br /> Owner&Co�lractor sign back of application,notarized(Or,copy of signed contraat with owner)
<br /> If over$2500,a Notice of Commencement is required(Mechanicai work over$5000}
<br /> Suppiy two(2)sets of drawings with applicable documentation
<br /> Allaw 14-14 days for revisw after submittal date. � Parcel#-obtained fram Property Tax Notice(http://appraiser.pascogov.com)
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