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<br />813-780-0020 <br /> <br />Fax-813-780-0021 <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br />Date Received <br /> <br />II <br /> <br />II <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br />II <br /> <br />~ <br /> <br /> <br />~~~"', <br /> <br />Titleholder Phone Number <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />,~!W""."""""",fflOOi'1!-IIIiil~ <br /> <br /> <br />I Lot# <br /> <br />~~~~:iJfl)~ <br /> <br />~I~'_ <br /> <br />ri'i!1 <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br /> <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br /> <br />o <br />o <br />o <br />o <br />o <br />o <br /> <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 />(Ut:lIAINt:U t-KUM t-'KUt-'t:K I Y I AX NU 11l;t:) <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />- <br /> <br />'''''''.'''i.'~W''~~ <br /> <br />Parcel # <br /> <br />Sub Division <br /> <br />o <br />o <br />o <br />o <br />o <br />o <br /> <br />Contractor <br />Signature <br />Address I <br />ELECTRICIANI <br />Signature . <br />Address I <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature . <br />Address I <br />OTHER <br />Signature <br />Address <br /> <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br /> <br />Fumigation Tent <br />Hazardous Material (Tier 1\ or RQ Facility) ANNUAL <br />Hood Installation <br /> <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 <br />I Company \ <br />Registered <br />I License # r <br />I Company ~ <br />Registered <br />I License # I <br />I Company \ <br />Registered <br />I License # I <br />I Company \ <br />Registered <br />I License # I <br />I Company I <br />Registered <br /> License # <br /> <br />,I <br /> <br />~~il'im <br /> <br />l <br /> <br />...........~IiI_-- <br /> <br />I <br /> <br />Valuation of Project <br /> <br />Y/N <br /> <br />Y/N I <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N I Fee Current Y/N I <br /> I <br />Y/N I Fee Current Y/N 1 <br /> I <br />Y/N I Fee Current [ Y/N <br /> <br />Directions: <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 />