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<br />813-780-0020 <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Date Received <br /> <br />/ 2.. -1.. 6-07 <br /> <br />Owner's Name <br /> <br />fJ/lS(O Hr1A J/{)L <br />/.] cR) h I'tr ~ ~c:I <br />I <br />I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br /> <br />Owner's Phone Number I 5 5'- l.. II S- L ( Ill; au I <br /> <br />I <br /> <br /> <br />I Titleholder Phone Number II II I <br /> <br />I <br /> <br />Fee Simple Titleholder Address <br /> <br /> <br />Job Address 6l/~ <br />Sub Division <br /> D Bio-Hazard Waste Storage - ANNUAL <br /> D Comm Exhaust Kitchen Hood/Duct <br /> D Controlled Bum <br /> D Emergency Generator < 30 kw <br /> D Emergency Generator> 30 kw <br /> ~ Fire Protection Maintenance - ANNUAL <br /> Sprinkler [gJ <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 />/2?J/() iJ /l <br />I <br /> <br />2 (::Jl/P<-y 6l(J ".c( ") J..ry( <br /> <br />Lot # <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Parcel # <br /> <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> <br />Hood Installation <br /> <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br />Recreational Bum <br /> <br />^,' .-"- .-,,_.- "".~"'"'' <br /> <br /> <br />(:~~ <br /> <br />Sparklers <br />Sprinkler System Installations <br /> <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIANI <br />Signature . <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br />Signature <br />Address <br /> <br />..- <br /> <br /> <br />~-l <br />~~ <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 />Y I N Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />. Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />License # I I <br />m~n~&~&iiliii1~ii:~~WJf.81.~:illtrit<;.;;'~{.'$~~k.~ilif~*m~~~w~1t.~JZW""~: <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 />