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<br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br />JJ 1 f 'If> <br /> <br />Fax-813-780-0021 <br /> <br /> <br />II <br /> <br />II <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />Job Address <br /> <br />/-terM ~ <br /> <br />I Lot# <br /> <br />Sub Division <br /> <br />I ;2e.ph r r iJ a '0 ~V\. <br />I ~56 A- 4 c." t-- <br /> <br />n u.. ,,^ 5(n~ <br />I Parcel # <br /> <br />tVt:S I AINt:U rKVIVI t"'KVt"'t:K I Y I IV.. I'IV 11\.;t:) <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Contractor <br />Signature c. <br /> <br />Address <br /> <br />ELECTRICIAN <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICA~ <br />Signature I <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />Sprinkler D <br />Fire Alarm D <br />Hood Clean/Suppression [J.:d- <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />D Fumigation Tent <br />D Hazardous Material (Tier" or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />D Places of Assembly-ANNUAL <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Other: <br /> <br /> <br /> Company ISfrn~{r ~r"'ll (( <br /> Registered Y I f.J Fee Current Y I N <br />to License # I (:.;:; 00 of 2-11 <br /> Company I <br /> Registered Y/N I Fee Current Y/N <br /> License # I <br /> Company I <br /> Registered Y/N I Fee Current Y/N <br /> License # I <br /> Company I <br /> Registered Y/N I Fee Current Y/N <br /> License # I <br /> Company I <br /> Registered Y/N I Fee Current Y/N <br /> License # <br /> <br />Fill out application completely. <br />Owner & 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. <br />