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<br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br /> <br />~eC'\ .- tJ~\ \ ~Cc:z.e.if2- <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Owner's Phone Number <br /> <br />~t3 <br /> <br />117<gZ <br /> <br />1155~ I <br />I <br />I <br />I <br /> <br />II <br /> <br />I <br />I <br />/38',;lso j) <br />I <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />j}~ <br /> <br />I Lot# <br /> <br />Parcel # <br /> <br />(Vt:ll AII'\I~U rKVIVI t'KVt'~K I Y I",^ I'\IV III.J~) <br /> <br />D <br />D <br />D <br />D <br />D <br />W <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-Hazard Waste Storage - ANNUAL <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 l2r' <br />Fire Alarm D <br />Hood Clean/Suppression D <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />D Fumigation Tent <br />D Hazardous Material (Tier II 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 Re~eationalBum <br />D Sparklers <br />C!lr 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 />Contractor <br />Signature <br /> <br />Address I ~7C>1 OC4."-. f1;.t. [ll- 7t4nt.JI)~ H... 6:140 <br /> <br />ELECTRICIAN <br />Signature I <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address <br />Directions: <br /> <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # <br /> <br />S""'OTY &-r."~U <br />Y I N . Fee Current Y I N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y / N . I Fee Current <br /> <br />Y/N <br /> <br />Y / 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 />