Laserfiche WebLink
<br />() f-k{ <br /> <br />Fax-813-78~0021 <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />813-78~0020 <br /> <br />" <br />___ Phone Contact for Permit ~if/:Jf?' <br />iKi /1//e Y /,Ie> rn ~,1 ~';6'C(ml' I '1: Owne<'s Phone N",,'" Il? 1.:3 117 n I I "?,PO <br />~ 0, Eo ::3:3~r;y; ale C c2 :?~.3 <br /> <br />Date Received <br /> <br />ner's Name <br /> <br />OWner's Address <br /> <br /> <br />II <br /> <br />II <br /> <br />Titleholder Phone Number <br /> <br />Fee 'Slmple Titleholder Name <br /> <br />I <br />IS3.l/~ _ ?'rh 5t- <br />I <br /> <br />Fee Simple Titleholder Address <br /> <br />I Lot# <br /> <br />Job Address <br /> <br />'1 <br /> <br />Parcel # <br /> <br />t vts I AII'IIt:U r-KVM t'KVt't:K I 1 I",,^ I'\IV 111..t:} <br /> <br />Sub Division <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 />o Bic-Hazard Waste Storage - ANNUAL <br />'0 Comm Exhaust Kitchen Hood/Duct <br />o Controlled Bum <br />o . Emergency Generator < 30 kw <br />U Emergency Generator> 30 kw ." . <br />~ FIre Protection M...tenan~ <br />Sprinkler <br />. Fire Alarm ~ <br />Hood Clean/Suppression D <br /> <br />Sparklers <br />Sprinkler System Installations <br />StandpipeS (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />o Fire Alarm Installation <br />o Fire Pumps <br />. 0 Fire Works <br />o Flammable Application- ANNUAL <br />o Fuel Tanks <br />o Other: I <br /> <br />== i~~~. .1. <br /> <br />ELE;;:::":Y.sI71 w. wptct-s A"ey71t~gJ ~1- ~~~j <br /> <br />Signature . '. - . <br />Address II <br /> <br />I I <br />I <br />I <br />I <br />I <br />I <br /> <br />I <br /> <br />Valuation of Project <br /> <br />Edt])! .sec~'C'i~( r$"E?:rvJces <br />__Y/N I FeeCUrren I Y/N_ <br />I ~P"CJPO//:2...:3 I <br /> <br />I Y IN I Fee Current I Y I N I <br />I I <br /> <br />j Y I N I Fee Current I Y I 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 /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANIC4 <br />Signature . <br /> <br />Address I <br /> <br />OTHER I <br />Signature <br /> <br />Address I <br />Directions: <br /> <br />Company <br />Registered <br /> <br />Ucense # <br /> <br />Company <br />Registered <br /> <br />Ucense # <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 />