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<br />813-780-0020 <br /> <br />City of Zephyrhills Fire <br />.Permit Application <br /> <br />1 tfq 1 <br /> <br />Fax-813-780-0021 <br /> <br />- . <br /> <br />Phone Contact for Permit <br /> <br />Date Received <br /> <br />8'1..:3 1.17 ff 0 II ~~ ~ " <br /> <br />ner's Name <br /> <br />iFM C 11 &lor ~et s~"~e 1 YlC <br />S ~ 1.:gs-Mll.'rKet S LLCl.re <br />I <br />I <br /> <br />I :3 f? 135 1'1 iJ-'f" K.e t SCf:.. l.(t;l,t' e <br />r <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br />Fee .Slmple Titleholder Name <br /> <br />II <br /> <br />I TItleholder Phone Number I <br /> <br />OWner's Address <br /> <br />Fee Simple Titleholder Address <br /> <br />(fIDrirlILHd.ical C/[/'Jic) I Lot' <br />. Parcel # I. <br />lvtj I AINCU rKVIVl t'KVt'cK I T I AA N.V III...C} <br /> <br />I <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />D Bio-Hazard Waste Storage - ANNUAL <br />D Comm Exhaust Kitchen Hood/Duct <br />D Controlled Bum <br />o . Emergency Generator < 30 kw <br />U Emergency Generator> 30 kw <br />~Fire protectiOn.Malntenan~ <br />Sprinkler <br />. Fire Alarm ~ <br />Hood OeanlSuppresslon 0 <br /> <br />Fumigation Tent <br />HazardOUS Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br /> <br />LP/Natural Gas-Installation (0 <br /> <br />LP/Natural Gas-ANNUAL Sale .~!Bfo~.. I . I :J <br />Places of Assembly-ANNUAL P v'q,q f J.f)}~ <br />Recreational Bum "J ~ .1'- <br />Sparklers ~I in Ir <br />~w~n . <br />IVl.n ((e.- rfb D <br />5F fA" 1 <br /><oOItl . <br />813~. . <br /> <br />.1 ValUatiOn~ct <br /> <br />Sprinkler System Installations <br /> <br />D Fire Alarm Installation <br />D Fire Pumps <br />D Fire Works <br />D Flammable Application- ANNUAL <br />o Fuel Tanks <br />D Other: I <br /> <br />=~ [~~-l <br />~=::~~YI w. W~rr.H ;rre)~mpa FL93~~~1 <br />Address I I <br />~M~ II <br />Signature . . <br /> <br />~~I I <br /> <br />MECHANICALlI. <br />Signature . I . <br />Address I I <br /> <br /> <br />! <br /> <br />Standpipes (Sprinkler Sys) <br /> <br />Torch Roofing <br />Waste TIre Storage ANNUAL <br /> <br />Company I~Dr SeCu'l'IC(SerY1ce5 <br />Registered r::s:z:E] Fee CUrrent __ Y IN. <br /> <br />I <br /> <br />Company I <br />Registered <br />I <br /> <br />.1 <br />I <br />I <br />I <br />I <br />J <br /> <br />J=F "t){//I~ <br /> <br />I <br /> <br />Y IN I <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />License # <br /> <br />Y/N I <br /> <br />Fee Current I <br /> <br />License # <br /> <br />Company <br />Registered <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 />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />OTHER <br />Signature <br /> <br />Address I. <br /> <br />Directions: <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 />