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<br />'131:3-780:0020 <br /> <br />iLt1>V <br /> <br />City of Zephyrhills Fire <br />Permit ;A.pplication <br />I <br />Phone Contact for Permit <br /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Job Address <br /> <br />I <br />I <br />17'")C:~ <br />- <br /> <br />I <br /> <br />b-a II f5 I <br /> <br />(}:fa/1 t7( <br /> <br /> <br />I j Parcel # <br /> <br />Fee Simple Titleholder Name <br /> <br />Fax-813-780-0021 <br /> <br /> <br />II <br /> <br />/I <br /> <br />Owner's Phone Number <br /> <br />I Titleholder Phone Number <br /> <br />/I <br /> <br />II <br /> <br />Fee Simple Titleholder Address <br /> <br />Sub Division <br /> <br />()J( e.i ) <br />/ <br /> <br />I <br /> <br />I Lot# <br /> <br />(Uti I AINcU f-KUM t-'KUt-'cK I Y I AX NU IIL;c) <br /> <br />I D Fumigation Tent <br />D Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />D Places of Assembly-ANNUAL <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <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 />I ~mergencY Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />Sprinkler D <br />Fire Alarm D <br />W-- <br /> <br /> <br />D <br />D Fire Pumps <br />D Fire Works <br />D Flammable Application- ANNUAL <br />D Fuel Tanks <br />D Other: <br /> <br />Valuation of Project <br /> <br /> <br />Contractor <br />Signature <br /> <br />Address <br /> <br />ELECTRICIANj <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 /> <br />Address <br /> <br />I Company <br />I <br /> Registered <br /> License # <br /> Company <br /> Registered <br /> License # <br /> Company <br /> Registered <br /> License # <br /> Company <br /> Registered <br /> License # <br /> Company <br /> Registered <br /> License # <br /> <br />- -5, rn,':J J~ ~'nr>... 'f - <br />Y I N I Fee Current L Y I 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/N <br /> <br />Fee Current <br /> <br />Y IN I <br /> <br />Directions: <br /> <br />Fill out application completely, I <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 />