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<br />City of Zephyr hills Fire Fax-813-780-0021 ~
<br />Permit Application .'i, ,-'iJ \\..,'" 'k~
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<br />I I Titleholder Phone Number l II II I
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<br />Dec 26 07
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<br />11 : 16a
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<br />Specialt~ Electronic S~st
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<br />352-521-6085
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<br />813-780-0020
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Name
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<br />Fee Simple Titleholder Address
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<br />I Lot#
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<br />Sub Division
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<br />Emergency Generator> 30 kw
<br />Fire Protection Maintenance - ANNUAl.
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<br />Places of Assembly-ANNUAL
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<br />Fire Alarm
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<br />Recreational Bum
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<br />Sprinkler
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<br />Sparklers
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<br />Hood Clean/Suppression
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<br />Other: I
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<br />ELECTRICIANI Company I
<br />Signature . Registered , Y I N Fee Current Y I N I
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<br />Address I License # I I
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<br />I Company .1
<br />Registered . Y I N I Fee Current
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<br />License # I
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<br />Company I
<br />Registered . Y I N
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<br />License # I
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<br />OTHER I C I
<br />. ompany I N I I
<br />Signature . Registered Y Fee Current Y I N
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<br />Fire Pumps
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<br />Fire Alarm Installation
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<br />Fire Works
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<br />Flammable Application- ANNUAL
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<br />Valuation of Project
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<br />Fuel Tanks
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<br />Y/N
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<br />PLUMBER
<br />Signature
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<br />Address I
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<br />MECHANICALI
<br />Signature
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<br />Address I
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<br />Fee Current
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<br />Y/N
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<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.
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