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<br />813-780-0020 <br /> <br />Date Received <br /> <br />O....,er's Name <br /> <br />OWner's Address <br /> <br />City of-Zephyrhills Fire <br />Permit Application <br /> <br /># It 1.5 <br /> <br />Fax-813-78~21 <br /> <br />" <br /> <br />Fee .Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />Phone Contact for Permit <br /> <br />Y$/~'ir <br />1.17F'3 1.18?p/ <br /> <br />I Owner's Phone Number <br /> <br />I <br /> <br />I <br />Lot # <br /> <br /> <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen HoodJDuct <br /> <br />Controlled Bum <br /> <br />. Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br /> <br />Sprinkler <br />Fire Alarm <br /> <br />o _----.. <br />i~~ <br /> <br />Parcel # <br /> <br />(Pu.IJ/ix ) <br /> <br />- <br /> <br />I <br /> <br />l vtj I AII'lCU t"KVM t'KVt'cK I T I PIA NV III...C} <br /> <br />D <br />D <br />D <br />o <br />D <br />fEr <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANIC' <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address I <br />Directions: <br /> <br />Hood aeanlSuppression <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 /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />I <br /> <br />Valuation of Project <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />~ectll()1:vSerf//Le~ <br />UZ]!J Fee current' I .. Y I N I <br />I <br /> <br />Y IN I <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />I <br />J <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />yrN I <br /> <br />Fee Current <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N I Fee Current I Y/N <br />Y/N I Fee Current I Y/N <br />Y/N I Fee Current I Y/N <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <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 />