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<br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />813-780-0020 <br /> <br />City of Zephyr hills Fire <br />Permit Application <br /> <br /> <br />. \"2. _\'1-0 <br /> <br /> <br />II <br /> <br />Phone Contact for Permit <br /> <br />II <br /> <br />~":::\ <br />Or ~~k <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br />II <br /> <br />I Titleholder Phone Number <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />D <br />D <br />D <br />o <br />o <br />o <br /> <br />D <br />D <br />o <br />o <br />o <br />D <br /> <br />16'14-0 <br />I <br /> <br />s~\ L r 210 ( 0, I Lot# <br />Parcel # 1~~tl~~~U'!~K~~K I?<;-~ Nt'R&~ <br /> <br />.0--Fumigation Tent \ 0- 2<:0- 2..1 -OOOO-DO\OO.. 0000 <br /> <br />o Hazardous Material (Tier II or RQ Facility) ANNUAL <br />o Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />o Places of Assembly-ANNUAL <br />o Recreational Bum <br />D Sparklers <br />o Sprinkler System Installations <br />o Standpipes (Sprinkler Sys) <br />o Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <br />G ~&>-r\ brnok' 5+ <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />Srz.e.. ck4enk-- l2}bDO <br />~- <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 />Fuel Tanks <br /> <br />Valuation of Project <br /> <br />Other: <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIANI <br /> <br />Signature . <br /> <br />Address I <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br /> <br />Signature . <br /> <br />Address <br /> <br />OTHER <br />Signature <br /> <br />Address <br /> <br />Directions: <br /> <br />Company <br />Registered <br /> <br />Y/N <br /> <br />Y I N Fee Current <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />Y I N I' Fee Current <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />Y/N <br /> <br />, Y I N I Fee Current <br /> <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />License # <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 />