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<br />81" 780-0020
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<br />City otZephyrhills Fire
<br />Permit Application
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<br />Owner's Name
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<br />Fee Simple Titleholder Address
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<br />Sub Division
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<br />Contractor
<br />Signature
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<br />ELECTRICIAN
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<br />PLUMBER
<br />Signature
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<br />MECHANICALI
<br />Signature
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<br />Address I
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<br />I 31 <619 S R S l1 (~(7\\~y ~:\ \5
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<br />o Fumigation Tent
<br />o Hazardous Material (Tier II or RQ Facility) ANNUAL
<br />o Hood Installation
<br />D LP/Natural Gas-Installation
<br />o LP/Natural Gas-ANNUAL Sale
<br />[S!;J Places of Assembly-ANNUAL
<br />o Recreational Bum
<br />o Sparklers
<br />o Sprinkler System Installations
<br />D Standpipes (Sprinkler Sys)
<br />D Torch Roofing
<br />D Waste Tire Storage ANNUAL
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<br />J Valuation of Project
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<br />Bio-Hazard Waste Storage - ANNUAL
<br />Comm Exhaust Kitchen Hood/Duct
<br />Controlled Bum
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<br />. Emergency Generator < 30 kw
<br />Emergency Generator> 30 kw
<br />Fire Protection Maintenance - ANNUAL
<br />Sprinkler D
<br />Fire Alarm D
<br />Hood Clean/Suppression D
<br />Fire Alarm Installation
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<br />Fire Pumps
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<br />Fire Works
<br />Flammable Application- ANNUAL
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<br />Fuel Tanks
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<br />I' 1'''" IT 'F"iI'i'iMil'''
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<br />ft1~1 -5
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<br />Fax-813-780-0021
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<br />License #
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<br />Company
<br />Registered
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<br />License #
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<br />Company
<br />Registered
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<br />License #
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<br />Company
<br />Registered
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<br />License #
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<br />Y/N
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<br />Fee Current
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<br />Fee Current
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<br />OTHER
<br />Signature
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<br />._"""<1 A~dress J
<br />Directions: "'l....ti".''''".;;.;-,..''';:,;,;,;.,;;,..:'.. '",,-,' "'''''"''''''';(,^' ~''ilQ"~'
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<br />Fill out application compietely.
<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.
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<br />Company
<br />Registered
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