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<br />Date Received <br /> <br /> <br />City of Zephyrhifls Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />C (;,. Y1 0.. <br /> <br />()J)k <br /> <br />Owner's Phone Number <br /> <br />Fax-813-780-0021 <br /> <br />II <br /> <br />II <br /> <br />Owner's Address <br /> <br />" <br /> <br />I <br /> <br />Fee Simple Titleholder Address I <br /> <br />----.~ j~ (; .?J. ~T <br />Job Address I ~ ~ / / Y(J <br />I I <br /> <br />Fee Simple Titleholder Name <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />~4!jm <br /> <br />Parcel # <br /> <br />\UI:II AINt:.U r-KUIVI t"'KUt"'t:.K I Y I f\A I'IU 11L.t:.) <br /> <br />Sub Division <br /> <br />D Bio-Hazard Waste Storage - ANNUAL <br />o Comm Exhaust Kitchen HoodlDuct <br />D Controlled Bum <br />D Emergency Generator < 30 kw <br />o Emergency Generator> 30 kw <br />00 Fire Protection Maintenance - ANNUAL <br />Sprinkler [XI <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 />~ Other: <br /> <br />1m!~I!M~1 <br /> <br />Lot # <br /> <br />&~~~ <br /> <br />I I <br />I <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 /> <br />Contractor <br />Signature <br />Address <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />ELECTRICIAN <br /> <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <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 />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />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 />