Laserfiche WebLink
<br /> <br />3 Simple Titleholder Name <br /> <br />te Received <br /> <br />mer's Nam~ <br /> <br />mer's Address <br /> <br />City of.Zephyrhills Fire, <br />,Permit Application <br /> <br />Phone Contact for Permit <br /> <br />Fax-81~780-0021 <br /> <br /> <br />(p <br />1'/'!JlJ;-:}' I .I jZOO <br /> <br />Owner's Phone Number J {p I D <br /> <br />" <br />" <br />J 7J A/B <br />I <br /> <br />liitieholder Phone Number <br /> <br />II <br /> <br />II <br /> <br />, Simple Titleholder Address <br /> <br />I Address <br /> <br />) Division <br /> <br />a ;4-/1 3/v/' <br />I <br /> <br />~.~ ~ Lot # <br /> <br />'J <br /> <br />\ Uti I AII'IIcU r~UIVJ t"~Ut"C~ I r 'AA NUl 'l.C) <br /> <br />Parcel # <br /> <br />Sic-Hazard Waste Storage - ANNUAL <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br /> <br />~ <br />D <br />,0 FireWorks <br />D Flammable Application- ANNUAL <br />o FuelTanks <br />o ~Other: <br /> <br /> <br />I ....;L''' _ /1- ./ I Company <br />,~ Li-L.-/". Registered <br /> <br />~(fbF.,('"Ty F/Jj .3%"icense# I <br /> <br />Company I <br />Registered <br /> <br />I I <br /> <br />I I <br />I 'I <br />I I <br />I I <br />! ! <br /> <br /> <br />.' " <br /> <br />,0 <br />D <br />o <br />o <br />D <br />D <br /> <br />,tractor <br />nature <br /> <br />Address i ts"'f<lll1 <br />:CTRICIAN <br />1ature <br />Address I <br />JM8ER I <br /> <br />o <br />D <br />D <br />o <br />D <br />D <br />D <br />o <br />Hood Clean/Suppression D . D <br />Fire Alarm Installation -' ~\~ 0 <br />Fire Pumps , CSb ~ ~ 0 <br />o <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />. Emergency Generator < 30 kw <br /> <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br /> <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br />Recreational Bum <br /> <br />~\~~ <br />ir~ <br /> <br />Sprinkler <br /> <br />.~ <br /> <br />Sparklers <br />Sprinkler System Installations <br /> <br />Fire Alarm <br /> <br />Standpipes (Sprinkler Sys) <br /> <br />Torch Roofing <br /> <br />Waste Tire Storage ANNUAL <br /> <br />CJoo <br /> <br />a::;:J <br /> <br />Valuation of Project <br /> <br />I~t~\~ ~~D <br />{ N Fee'Current IN <br /> <br />GF - fXJOO IDl.I (p <br /> <br />I <br /> <br />Y IN' <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br />'. <br /> <br />""""'"', <br /> <br />Y/N I <br /> <br />Fee Current <br /> <br />License # <br /> <br />1ature <br /> <br />Address I <br /> <br />::HANIC4 <br />,ature . <br /> <br />Address I <br /> <br />Company <br />Registered <br /> <br />Fee Current I <br /> <br />Y/N <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />Y/N , <br /> <br />Fee Current I <br /> <br />Y/N <br /> <br />License # <br /> <br />iER <br /> <br />lature <br />Address L. <br />ctions: <br /> <br />Company <br />Registered <br /> <br />Fee Cu",,", . I <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 /> <br />Y IN <br /> <br />,;';'O'K...,..... <br /> <br />License # <br /> <br />.,..,.",,-~,.,..:=.u'~ <br /> <br />. =~'~'-~"W <br /> <br />.~,.;;.:v__ <br /> <br />....... " <br /> <br />~" <br />