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<br />City of.Zephyrhills Fire <br />. Permit Application <br /> <br />Phone Contact for Permit <br /> <br />813-780-0020 <br /> <br />1- -z9<>1 <br />17 own u,"tbJ /.e~ L LLc <br />I 12- 5 C!-d~~ SA ~ tJck sr <br />I <br />I <br />::,",,---i73<1~ C;ol(p(ffI/ ~-<fLl <br /> <br />I . I . Parcel # <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />III <br /> <br />_J,,,,,,,,,,,,,,,,,,..-w <br /> <br />n' lIW'l" 17'w-=~ <br /> <br />Fee Simple Titleholder Address <br /> <br /> <br />II <br /> <br />I J <br /> <br />I Owner's Phone Number <br /> <br />r;/~ ~rI <br /> <br />I Titleholder Phone Number <br /> <br />f'L <br /> <br />II <br /> <br />II <br /> <br />Sub Division <br /> <br />~m <br /> <br />~ ~ TI <br /> <br />I Lot# <br /> <br />I <br /> <br />(Vt) I f\II\1~LJ rKVIVI t"'KVt"'t:K I Y I f\A I\lV II\"~) <br />J r - r iii: <br /> <br />- <br /> <br /> <br />D Fumigation Tent <br />D <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D <br />D Places of Assembly-ANNU <br />D Recreational Bum <br />D Sparklers <br />~ Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />D Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <br />.0 Bio-Hazard Waste Storage - ANNUAL <br />o Comm Exhaust Kitchen Hood/Duct <br />o Controlled Bum <br />D Emergency Generator < 30 kw <br />o Emergency Generator> 30 kw <br />o Fire Protection Maintenance - ANNUAL <br />Sprinkler D <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 />D Other: <br /> <br />Valuation of Project <br /> <br />Contractor <br />Signature <br />Address <br /> <br /> <br />ELECTRICIAN <br /> <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALl <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br /> <br />Signature <br /> <br />Address .L ..... <br /> <br />Directions: <br /> <br />''''''''''''''"''"-',.-,,,,,,,,'' <br /> <br />=....... <br /> <br />'"","""'" <br /> <br />""'"''''''....".. <br /> <br />''"'''M''1'~~ ,.'~'." ~~~. .~' _~'k,_>_c", <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 />Y/N <br /> <br />I ff::c./513/3 7 <br /> <br />I Y IN' Fee Current <br />I <br /> <br />I Y IN <br />I <br /> <br />I Y/N <br />I <br /> <br />I Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />,,1- .;._"'.....>,>".."''"~.~'"'''''i1-.:.m...._'''''"'~.......-=..__'''''~:..i_~,..'"'...,.-fil.'t.w'Pii,"""""'L...... <br /> <br />" .....;fU_, <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 />