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<br />Date Received <br /> <br /> <br />City of.Zephyrhills Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />j 13A-!-!JIJ-/{t1- I.J dll-lJlN~e?;Jjll-- v <br />5 t!'}CJC' II r;..t! JI/ L <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Fax-813-780-0021 <br /> <br />II <br /> <br />Owner's Phone Number <br /> <br />I J <br /> <br />Titleholder Phone Number <br /> <br />II <br /> <br />Parcel # <br /> <br />WT <br /> <br />~"'IiF'~"Ii~~~!'l!''''''-t... <br /> <br />-r <br /> <br />1Iil <br /> <br />--i'JIiili fllfTTI 1 <br /> <br />rrr'\~-fr "'"" <br /> <br /> <br />D <br />D <br />D <br />D <br />D <br />D Other: I <br /> <br />Contractor ... ~J:.3~ <br />Signature ~ ~ C-c:::. <br /> <br />Address I f' /~ 1- /3<< /l UVtn '- f< /) . <br />ELECTRICIAN <br />Signature I <br /> <br />Address I <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Job Address <br /> <br />13~?OO <br />I <br /> <br />I\-fYl <br /> <br />Aue- <br /> <br />Lot# <br /> <br />I <br /> <br />(UbJAII'IIl:U r-KUIVI t"'KUt"'t:KJ Y IAA I'IIUlll.l:) <br />TT ~~='ZU .-.......'lI";;t;T~if - 'C~ ~ J ~,I&QM. <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br /> <br />S~d- <br /> <br />(~\~ <br /> <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <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 />Company <br />Registered <br /> <br />License # <br /> <br />~~,,- <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 />Valuation of Project <br /> <br />WfW" <br /> <br />1~ <br /> <br />v<'il ~_,ii""'W'''"''''''' <br /> <br />I>.'~ <br /> <br />Sub Division <br /> <br />~"",..=:tll!~~ <br /> <br />~... -- - ;Jl_IIi\"".~1 "rnw- <br /> <br />D BiD-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 D <br />Fire Alarm D <br />Hood Clean/Suppression gj <br /> <br />~Bir:r;m <br /> <br />... <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address I <br />~ ;".;,.,...~ <br />Directions: <br /> <br />...""",,.;,;'u.....-.......,,, ,....'.. -",..;."",="';_~,..,,,,,,, "~""'_'~''''_~'Jijj'''':'_.''''~''''''''''''''''' <br /> <br />-~.' ~ ~"".~"""~ <br /> <br />:11 <br /> <br />I(cry[p~ Qy Q'~-Lb <br />Y I N Fee Current Y I N <br />I <br /> <br />I Y IN <br /> <br />Fee Current <br /> <br />Y/N <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 />..! _h_'''''''''''",__."."'._. .,~.._..._..,,"_".""""".~-.==.L"'"o_ <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 />