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<br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fax-813-780-0021 <br /> <br />City of.Zephyrhills Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br /> <br />Fee Simple Titleholder Name <br /> <br />!J~.u-,g <br />I <br />I <br />~~~'f':;:;3'-;~..Br., · .",fL :33'> ~..---- ~ i-~ <br />S,bDivi,ion ~~ I \U.'A':U'K~~" ',,^"u"~e) <br /> <br /> <br />~~, :;:Ml\IV.l~*~1W,,!?J~ ilW5 lVJl N 1m -k-....~Iim~ia!~r-=m-- IT" ,,~~~~ <br /> <br />Fee Simple Titleholder Address <br /> <br />D <br />D <br />D <br />D <br />D <br />E8J <br /> <br />!!iIt.1!Il,*_ <br /> <br />Contractor <br />Signature <br />Add~" : rlf{.( <br />ELECTRICIAN <br />Signature <br />Address I <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHAN I CALI <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br /> <br />Signature <br /> <br />~. ill Addre~L"..... <br />Directions: <br /> <br /> <br />~~r <br /> <br />er's Phone Number <br /> <br />I <br />PL <br />I <br /> <br />II <br /> <br />II <br /> <br />~ ..>$" 7A- W) <br /> <br />a <br /> <br />~3te~ <br /> <br />II <br /> <br />II <br /> <br />I Titleholder Phone Number <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br /> <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br /> <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />'i:l<' <br /> <br />'lI'T <br /> <br />W"'i~~~ r <br /> <br />~~~ <br /> <br />Company I <br />Registered <br /> <br />License # I <br /> <br />Company I <br />Registered <br /> <br />License # I <br /> <br />Company I <br />Registered <br /> <br />License # I <br /> <br />Company I <br />Registered <br /> <br />License # I <br /> <br />Company I <br />Registered <br /> <br />License # . ",L <br /> <br />Y I N I Fee Current <br />.l:::.7-00t::>/1./l. :3 <br /> <br />Y/N <br /> <br />D Fire Alarm Installation <br />D Fire Pumps <br />D Fire Works <br />D Flammable Application- ANNUAL <br />D Fuel Tanks <br />D Other: I <br />~_~~~nh ~ <br />I~~I <br />W'W~ a.,.~ ~~J FL .$i~}J <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br /> <br />Sprinkler <br />Fire Alarm <br /> <br />~ <br />D <br /> <br />Hood Clean/Suppression <br /> <br />,<;~=''''"",;Jw;';';,;;'''':''_;;;&;;';..;i:O:.ij"~-_'x;.:..:i';;'k''.''~''''" ""'""'=~=-'''',",'''-''''''''''' <br /> <br />'" ..~..__. ~.".".,"...~,..l <br /> <br />Y/N <br /> <br />Y I 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 />Y I N I Fee Current <br /> <br />Y/N <br /> <br />'h-"..',., ~-:~f f'lki-"-t!lf-'\'l';"";.n~ <br /> <br />I <br />'--~"~"':V"W~~~*",~"""="""^"'~~ <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 documentatiofl <br />Allow 10-14 days for review after submittal date. \ <br />