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<br />~~~~:' LaaJ~.~ <br />. I.~; PL ~ ' ~ <br /> <br /> <br />Fee Simple Titleholder Name I ' I Titleholder Phone Number I II II I <br /> <br />I I <br />l,.\JD <br />I I <br /> <br />813-780-0020 <br /> <br />Date Ret:eived <br /> <br />.,. Owner's Name <br /> <br />- Owner's Address <br /> <br />City of Zephyr hills Fire <br />Permit Application <br /> <br /> <br />Fee Simple Titleholder Address <br /> <br />- Job Address <br /> <br />Sub Division <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br /> <br />I Lot# <br /> <br />Parcel # <br /> <br />{uts IAINcU t-KUMt-'KUt-'cK I Y lAX. NU IIL;c) <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br /> <br />o <br />o <br />o <br />o <br />o <br />~ <br />o <br />o <br />o <br />o <br />o <br /> <br />Fumigation Tent <br />Hazardous Material (Tier 1\ or RQ Facility) ANNUAL ~ (2.~ <br />Hood Installation ~ r.r"\ ~vt <br />LP/Natural Gas-Installation "\)l ~J-\ 0 <br />LP/Natural Gas-ANNUAL Sale r' <br /> <br />:::,::,:o-ANNUAL 1 ~/ ~ <br /> <br />Sparklers ct <br />Sprinkler System Installations <br /> <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />Other: <br /> <br />Valuation of Project <br /> <br />Fuel Tanks <br /> <br />I <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />D <br />D <br />D <br />o <br />o <br />D <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 />Fire Works <br />Flammable Application- ANNUAL <br /> <br /> <br />.,contractor <br />Signature <br /> <br />ELECTRICIAN <br />Signature <br />Address I <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature . <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y I N Fee Current <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y I N Fee Current <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Address <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 atter submittal date. <br />