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<br />City of Zephyr hills Fire <br />. Permit Application <br /> <br />4~=~7,:~~~_~L_L!LL:,L~~'~'~ML~4w_1'&_~=~~l~L~'~,,",~1l1t~~_JJ~,~.{.jJ <br />I c 1// L I 'f I Owner's Phone Number I II II I <br />I I <br />I <br />I <br />I <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />-* 1'}~ll <br /> <br />Fax-813-780-0021 <br /> <br />Fee Simple Titleholder Name <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />II <br /> <br />I <br />I <br />I 7t~/? <br />I <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />G~t{ <br /> <br />dLY/ <br />I <br /> <br />Parcel # <br /> <br />I Lot# <br /> <br />11?/-Z 5- '2/ -pc/tJ- ()'3/~p -"()PP I <br />(VI:) I f\1I'\1~U rKVIVI t"'KVt"'~K I Y I fV\ I'\IV 11l;~) <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 />D <br />D <br />[Z] <br />D <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />I POO, <br /> <br />Valuation of Project <br /> <br />"If <br />- <br /> <br />Fuel Tanks <br /> <br />Company <br />Registered <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 />Company <br />Registered <br />License # <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br /> <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />Sprinkler 0 <br />Fire Alarm 0 <br />Hood Clean/Suppression 0 <br />Fire Alarm Installation <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Other: <br /> <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIAN <br /> <br />Signature I <br /> <br />Address I <br /> <br /> <br />Address <br />Directions: <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 I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <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 />