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<br />DEC/07/~007/FRI 09:47 AM ZEPHYRHIL~S BUILDING
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<br />" FAX No. 813-780-0021
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<br />City of Zephyr hills Fire
<br />.Permit APpl.lcation ,
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<br />Oats Received. ..:.-' : " , ' "Phone .Conta~ for Permit
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<br />Own.... __ . C-1rL,4/<E MS~- {!ASf'fiiS. e.. ~.,;. Phon~Numb.r r
<br />own....Add- [19" g Y. AlMS',MI. S'rL-~/l fl.-. 3~
<br />Fso Slmpl~ TW....~er N.IIl- . .. r . .. . .. ~l. T_OIderPhone ~~ [
<br />Fee Simple Titleholde~ ~dd~e$S ,'I' " ' ' ' ,
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<br />813-780-0020
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<br />Job Address
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<br />Sub Division
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<br />contractor
<br />signatUre
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<br />Addre5&
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<br />ELECTRICIAN
<br />Signature "
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<br />'. .,Add!~
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<br />PLUMBER
<br />sign~ture '
<br />. Add~s.
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<br />MECIiANI
<br />, SIgnature
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<br />P. 004
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<br />Fax:..s13.780-0021
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<br />elo.Ha%8rd Waste Stolilse ~ ANNUAL
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<br />Camm Exh~ust K!tchet:' HciodlOuCt
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<br />Controlled B,um '
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<br />, Emergency Generator, < 30 kw
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<br />Emergenoy Generator >,30 kW' ,
<br />.. . '
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<br />Fire Proter;tlon Maintenance - ANNUAL ' ,
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<br />Sprinkler 0
<br />'Flre Alarm ,:',' 0' ,
<br />Hood Clean/Suppression 0
<br />Are Alarm InSUlllaUon
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<br />FIre pumps
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<br />Fire Worl<&
<br />Flammable Appllcation- ANNUAL
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<br />Fuel Tanks
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<br />Other:
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<br />. .,. 33S-<l1-
<br />60/,lZGA~ ,8L11IJ1c#*,,,NLS ,eLf- [
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<br />. ,I ,parcel # ,L. : I
<br />, I \Vg I Jo\INCU t'KvM 1:'1'\ 1"'[:1'\.1 T I/Vo. I'(U Ilut;;}
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<br />
<br />, . 0 FUmigaUonTent" " .' I ",.
<br />
<br />, '0 HazardoU& M~lerlal (TIer 11 or ~Q Faclllty~ ANMUAL
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<br />: 0' Hood In~tallation , ' I
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<br />o 'l-P/Natu",,1 Ga5-lnstal\~tion I' '
<br />o L.P/Natural Gas-ANNUAL Sille I!
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<br />'0: Places of'Assembly-AN~UAL I
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<br />,0 Recreational E1!Jffi, . I
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<br />. 0" sparkl~rs ',' I
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<br />o "Sprinkler System ,lnstal\~O~S I
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<br />o Standpipes (sprlnJ<ler Sys) i .
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<br />o Torch Roofing !
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<br />Q Waste Ttnl Storage ANNU.AI- LJ I
<br />~~6f17BL.V F~f/7"'
<br />, , . C- , ,', I V~'uatlo? of, Project
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<br />~mpany I - .,.~, -
<br />_._ t .Y I N r Foe """"frtL Y I N-=r
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<br />UCen&B I ". . ' :',
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<br />ucense# .l ' !
<br />Company .j . ' ' j,
<br />'R~lste(lld, .Y i N--1 . 'Fee currtt l
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<br />Regl~:' t Y I N:J Fee CUlT,nt .[~Y I N J
<br />cense# i ' ! ' -=:J
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<br />Fill out appllClltion completeiy:. '" ' , , '
<br />owner & ContractOr. sign back of application. 'notariZed (or. copy of signed contract with owner)
<br />If oVer $2500. a.Notice of Commenoement is required (Mt:!ooanlcaJ work ever $5000)
<br />~~pply: !N.? (2) sets of drawings with applicable documentation
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