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<br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br /> <br />Owner's Phone Number <br /> <br />Owner's Address <br /> <br />J ~/~ <br /> <br /> <br />11;JfJ 119' LJ~ ~I b>'-1L/~ I <br />31. <br /> <br />Owner's Name <br /> <br />II <br /> <br />II <br /> <br />Fee Simple Titleholder Name <br /> <br />Titleholder Phone Number <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />I (Y\\c\o-\-e.\ -t~3o... <br /> <br />I <br /> <br />~\\ t?i~& <br />I Parcel # <br /> <br />I Lot# <br /> <br />Sub Division <br /> <br />(Uti I AINt:U t"KUIVI t"'KUt"'t:K I T I AA NU 11l.t:) <br /> <br />D Bio-Hazard Waste Storage - ANNUAL <br />D Comm Exhaust Kitchen Hood/Duct <br />D Controlled Bum <br />D Emergency Generator < 30 kw <br />D Emergency Generator> 30 kw <br />D Fire Protection Maintenance - ANNUAL <br />Sprinkler [g} <br />Fire Alarm D <br />Hood Clean/Suppression D <br />D Fire Alarm Installation <br />D Fire Pumps <br />D Fire Works <br />D Flammable Application- ANNUAL <br />D Fuel Tanks <br />D Other: <br /> <br />D Fumigation Tent <br />D Hazardous Material <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 <br /> <br />Contractor <br />Signature <br />Address <br /> <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />I :r n+e\ "a...+1 C",Y\e-C- h':'c-P <br />Y I N I Fee Current I Y I N <br />I <br /> <br />ELECTRICIAN <br /> <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br /> <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address <br /> <br />Directions: <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y IN I Fee Current <br /> <br />Y/N <br /> <br />Pn:.-4ec\-t crI- <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />Company <br />Registered <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <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 />