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<br />813-780-0020 <br /> <br />41q,S'S <br /> <br />Fax-813~780-0021 <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br /> <br />Owner's Name I ~~ ~ed/{'J e~ - J+<;'~ in Dll fowners Phone Number I ~ II <;/2>0 I <br />I rc S a4C.u; A-Jlcr <br />I <br /> <br />Fee Simple Titleholder Address I I <br />:\~__~P~_i'I'_~_.Rl-""" -;!;::.;::__ma <br /> <br />Job Address I hi/U- /~ ~ .50~ (;,A-CC &y,/l 2sp'y.c./IIC Lot# ~-I I <br /> <br />I I Parcel # I I <br />(Utll AINt:;U I-KUM t-'KUt-'t:;K I Y I AX NU 11t,;t:;) <br /> <br />Owner's Address <br /> <br />rza. <br /> <br />PL <br /> <br /> <br />I Titleholder Phone Number I <br /> <br /> <br />" <br /> <br />g~g <br />II <br /> <br /> <br />Fee Simple Titleholder Name <br /> <br />II <br /> <br />Sub Division <br /> <br />JlWl!llII'Ii!!I1!I1" . <br />Contractor Company <br />Signature Registered <br />Address License # <br />ELECTRICIAN Company <br />Signature Registered <br />Address I se# <br />PLUMBER Company <br />Signature Registered <br />Address I License # <br />MECHANICALI Company <br />Signature Registered <br />Address I License # <br />OTHER I Company <br />Signature Registered <br />Address License # <br />Directions: <br /> <br /> <br />Sprinkler <br />Fire Alarm <br />~~ppression <br />Fire Alarm Installation <br />Fire Pumps <br /> <br />o <br />o Ix:ybi/IL <br />~ <br /> <br />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 <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />Valuation of Project <br /> <br />-~1J <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y / N Fee Current <br /> <br />Y/N <br /> <br />_ Y I N Fee Current <br /> <br />Y I N I Fee Current <br /> <br />Y/N <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 />