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<br />113'8<) <br />Fax-813-780-0021 <br /> <br />City of .zephyr hills Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br />e: 13-780-0020 <br /> <br /> <br /> <br />- fl.\ - 0<6 <br /> <br />Date Received <br /> <br />I~~~~ <br /> <br />Owner's Phone Number <br /> <br />TIer's Name <br /> <br />Owner's Address <br /> <br />II <br /> <br />II <br /> <br />I TiUeholder Phone Number I <br /> <br />I <br />I <br />1$3'1(5'3 <br />I <br /> <br />Fee Simple! TiUeholder Name <br /> <br />Fee Simple TlUeholder Address <br /> <br />I Lot# <br /> <br />5;d~, <br /> <br />AI'"'I\ . <br /> <br />Job Address <br /> <br />I <br /> <br />Parcel # <br /> <br />Sub Division <br /> <br />~Ulj I AII'It:U r-~UM ,...~u,...t:~ I Y I AA I'IU Ilvt:) <br /> <br />D <br />o <br />o <br />D <br />o <br />o <br />o <br />D <br />D <br />D <br />D <br />D <br /> <br />o <br />o <br />o <br />D <br />[j <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br />Recreational Bum <br /> <br />SIc-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen HoodlDuct <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />Sprinkler D <br />Fire Alarm ~ <br />Hood Clean/Suppression D <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Appiication- ANNUAL <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />D <br />D <br />o <br />D <br />D <br />o <br /> <br />'I Valuation of Project <br /> <br />AI ./11 <br /> <br />- <br />, <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />I Y/N I Fee Current I Y/N I <br />I I <br /> <br />I Y/N I Fee Current I Y/N I <br />I I <br /> <br />I Y I N I Fee Current I Y I N I <br />I I <br /> <br />I Y/N.I Fee Current I Y/N I <br />I I <br />IADr Se~u."riZ-7: Sa.rv/ce:j <br />. Y I N I Fee Current L Y I N I <br />IE F' '!.~t9 /(:< ~,I <br /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIAN <br />Signature I <br /> <br />Address I <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANIC', <br />Signature <br /> <br />Address I <br /> <br />I <br />I <br />~i:~::re I ~ ~ I <br />. ~ddress t~~?....,~~~,~ fT:./VIt/JP F.L 3.:Jq.t~ <br /> <br />Directions: iiiiiiii9 <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 /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />Company <br />Registered <br /> <br />Ucense # <br />