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<br />Date Recc:ived <br /> <br />Owner NlIJne <br /> <br />Owner Address <br /> <br />.' <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />I <br />I <br /> <br />1 \ - Jct . <br /> <br />Contact Phone Nbr <br /> <br />II 782 <br /> <br />Owner Phone <br /> <br />111100 <br /> <br />Sleepy Hollow MHP <br /> <br />813 <br /> <br />38615 Lansing -54 W <br />Fee Simpile Title Holder <br /> <br />I Titleholder Phone Nbr <br /> <br />II <br /> <br />II <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Addn:ss <br /> <br />Subdivision <br /> <br />38615 Lansing -54 W <br /> <br /> <br />Parcel ID <br /> <br />0'2 - 2(g - 2 \ <br /> <br />O'2<c,o _ 60000- 120-[) <br /> <br />B Bio-Hazard Waste Storage - ANNUAL <br />Cornm Exhaust Kitchen Hood - Duct <br /> <br />D <br />D <br />D <br />[ill <br /> <br />Controlled Bum <br /> <br />~tno <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />LP -- Natural Gas Annual Sale <br />Places of Assembly - Annual <br /> <br />Fumigation Tent <br /> <br />Hazardous Material (Tier II or RQ Facility) Annual <br />Hood Installation <br /> <br />Emergency Generator <30 KW <br />Emergency Generator> 30KW <br /> <br />Fil1~ Protection Maintenance - Annual <br /> <br />Sprinkler <br />Fire Alarm <br />Hood Clean -- Suppression <br />Fire alarm Installation <br />Fire Pums <br />Fire Works <br />f~ammable Application - Annual <br />Fuel Tanks <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Other: I <br /> <br />LP - Natural Gas Installation <br /> <br />D <br />D <br />l2t <br /> <br />B <br />B <br />B <br /> <br />Recreational Bum <br />Sparklers <br />Sprinkler System Installations <br />Standpipes ( Sprinkler System ) <br />Torch Roofing <br />Waste Tire Storage Annual <br /> <br />Value of Project <br /> <br />$1 I <br /> <br />Other Sign <br />Address <br /> <br />Contractor Sign <br /> <br />Address <br /> <br />Electrician Sign. <br /> <br />Address <br /> <br />Plumber Sign <br /> <br />Address <br /> <br />Mechanical <br /> <br />Address <br /> <br />Company <br />Registered <br /> <br />y <br /> <br />N I Fee Current I <br /> <br />License <br />Company <br /> <br />Registered <br /> <br />y <br /> <br />N I Fee Current I <br /> <br />License <br /> <br />Company <br /> <br />N I Fee Current I <br /> <br />Registered <br /> <br />y <br /> <br />~~6~ <br /> <br />118330 Lawrence Rd. Dade City, FI <br /> <br />License <br /> <br />Company <br />Registered <br /> <br />N <br /> <br /> <br />y <br /> <br />License <br /> <br />Directions: <br />Fill out application completely, Company <br />Owner & Contractor sign back of application, notorize ( Or signed <br />Copy of contract with owner) Registered <br />If over $2500.00. a Notice of Commencement is required <br />Mechanical wor1< of ( $5000,00 ) requires a Notice of Commencent <br />Supply two (2) sets of drawings with applicable documentation <br />Allow 10 -- 14 days for review after submittal date. <br /> <br />Security Fire Equipment, LLC <br />@ N I Fee Current I ~~ <br />502552000220004 <br />