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<br />City of Zephyrhills Fire <br />Permit Application <br /> <br />I <br /> <br />I <br />I <br />I <br /> <br />I 352-424-0906 <br /> <br /> <br />II 7RR ~ I <br />II II <br /> <br />Contact Phone Nbr <br /> <br />Date Received <br /> <br />IJ&200R <br /> <br />Owner Phone <br /> <br />Owner Name I <br />. Mom.on', Bulfo! <br />Owner Address . <br />Fee Simple Title Holder I <br />5420 Gall Blvd. <br /> <br />Fee Simple Titleholder Address <br /> <br />2711 <br /> <br />R13 <br /> <br />I Titleholder Phone Nbr <br /> <br />~LV.D, <br />I Parcel ID <br /> <br />157'20 <br /> <br />Lot Nbr. <br /> <br />C-4-tL <br /> <br />Job Address <br /> <br />Subdivision <br /> <br />B Bio-Hazard Waste Storage - ANNUAL 0 <br /> Fumigation Tent <br /> Comm Exhaust Kitchen Hood - Duct 0 <br />0 Hazardous Material (Tier II or RQ Facility) Annual <br />Controlled Bum 0 <br /> Hood Installation <br />0 Emergency Generator <30 KW LP - Natural Gas Installation <br />0 Emergency Generator> 30KW 0 <br />D Fire Protection Maintenance - Annual 0 LP - Natural Gas Annual Sale <br /> Sprinkler 0 0 Places of Assembly - Annual <br /> Fire Alann ~ <br /> Hood Clean - Suppression B Recreational Bum <br />0 Fire alann Installation Sparklers <br />0 Filre Pums B Sprinkler System Installations Value of Project <br />0 Filre Works Standpipes ( Sprinkler System ) $ I 1 <br />0 Fllammable Application - Annual B Torch Roofing <br />0 Fuel Tanks Waste Tire Storage Annual <br />0 ()ther: I <br /> <br />Company <br /> <br />Contractor Sign <br /> <br />N I Fee Current I <br /> <br />Registered <br /> <br />Address <br /> <br />y <br /> <br />License <br />Company <br /> <br />Electrician Sign. <br /> <br />Address <br /> <br />N I Fee Current I <br /> <br />Registered <br /> <br />y <br /> <br />License <br /> <br />Plumber Sign <br /> <br />Company <br /> <br />Address <br /> <br />N I Fee Current I <br /> <br />Registered <br /> <br />Mechanil::al <br /> <br />y <br /> <br />License <br /> <br />Address <br /> <br />Company <br /> <br />Other Sign <br /> <br />118330 Lawrence Rd. Dade City, FI <br /> <br />I <br /> <br />N I Fee Current I <br /> <br />Registered <br /> <br />Address <br /> <br />y <br /> <br />License <br /> <br />Directionll: <br />Fill out application completely. Company <br />Owner & Contractor sign back of application, notorize ( Or signed <br />Copy of contract with owner) Registered <br />If over $2500.00, a Notice of Commencement is required <br />Mechanical work of ( $5000.00 ) requires a Notice of Commencent <br />Supply two (2) sets of drawings with applicable documentation <br />Allow 10.-14 days for review after submittal date. <br /> <br />Security Fire Equipment, LLC <br />Y N I Fee Current <br />502552000220004 <br />