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<br />813-780-0020
<br />
<br />City of.Zephyrhills Fire
<br />Permit Application
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<br />P~~; Contact fo~:~=t 1~Li_U:::L.~-jrJYLI
<br />Owner's Phone Number I 8") 3 1/3) 2-113.>.1 J
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<br />Titleholder Phone Number I II II
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<br />Owner's Name
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<br />Owner's Address
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<br />~JlJll.l
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<br />Fee Simple Titleholder Name
<br />
<br />Fee Simple Titleholder Address
<br />
<br />Job Address
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<br />~~l~~/_~~l!I!:ie>TW--~li.1 '-'~y~ 11li
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<br />Y~YJ
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<br />Sub Division
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<br />/7/ /?PpRJ"" M/J-O
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<br />I Parcel #
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<br />rtf$<l
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<br />~~Qititi.t~~lli!ll'~~~. ,:.11 w1!1t\~1Y'"
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<br />Sio-Hazard Waste Storage - ANNUAL
<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 />
<br />D Fumigation Tent
<br />D Hazardous Material (Tier" or RQ Facility) ANNUAL
<br />D Hood Installation
<br />D LP/Natural Gas-Installation
<br />D LP/Natural Gas-ANNUAL Sale
<br />~ Places of Assembly-ANNUAL
<br />D Recreational Sum
<br />D Sparklers
<br />D Sprinkler System Installations
<br />D Standpipes (Sprinkler Sys)
<br />D Torch Roofing
<br />D Waste Tire Storage ANNUAL
<br />
<br />Comm Exhaust Kitchen Hood/Duct
<br />
<br />Controlled Bum
<br />
<br />Emergency Generator < 30 kw
<br />Emergency Generator> 30 kw
<br />Fire Protection Maintenance - ANNUAL
<br />Sprinkler D
<br />Fire Alarm D
<br />Hood Clean/Suppression D
<br />Fire Alarm Installation
<br />Fire Pumps
<br />
<br />Fire Works
<br />Flammable Application- ANNUAL
<br />
<br />Fuel Tanks
<br />
<br />m'illli
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<br />-k11li7
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<br />Fax-813-780-0021
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<br />I Lot#
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<br />Valuation of Project
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<br />Other:
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<br />Contractor
<br />Signature
<br />Address
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<br />~~~ '1'",.1_
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<br />ELECTRICIAN
<br />Signature I
<br />
<br />Address I
<br />
<br />PLUMBER
<br />
<br />Signature
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<br />Address I
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<br />MECHANICALI
<br />Signature ,
<br />
<br />Address I
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<br />Signature
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<br />Directions:
<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 />Company I
<br />Registered
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<br />License #
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<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 />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 />Y I N I
<br />
<br />Y/N
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<br />Fee Current
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<br />Y/N
<br />
<br />Fee Current
<br />
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