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<br />City of Zephyrhills Fire <br />Permit Application <br /> <br />I <br />I <br /> <br />Date Received <br /> <br />\{ -~~ <br /> <br />Contact Phone Nbr <br /> <br />Owner Nmne <br /> <br />I I 1202 <br /> <br />II 7R2 <br /> <br />Owner Phone <br /> <br />Owner Address <br /> <br />St. Elizabeths Episcopal Church <br />5855 16th St. <br /> <br />RB <br /> <br />Fee Simple Title Holder <br /> <br />I Titleholder Phone Nbr <br /> <br />II <br /> <br />II <br /> <br />Fee Simple Titleholder Address <br /> <br />lob Addrc..-ss <br /> <br /> <br />5855 16th St. <br /> <br />Subdivision <br /> <br />11- 2(,-2.-1 <br /> <br />ParcelID <br /> <br />0010 -b50Db-OO\D <br /> <br />B Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood - Duct <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) Annual <br />Hood Installation <br /> <br />D <br />D <br />D <br />till <br /> <br />Controlled Bum <br /> <br />Emergency Generator <30 KW <br />Emergency Generator> 30KW <br />Fire Protection Maintenance - Annual <br /> <br />LP - Natural Gas Installation <br /> <br />~o <br /> <br />LP un Natural Gas Annual Sale <br /> <br />D <br />D <br />[2J <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Sprinkler <br />Fire Alarm <br />Hood Clean un Suppression <br />F ire alarm Installation <br />Fire Purns <br />Fire Works <br />Flammable Application - Annual <br />Fuel Tanks <br /> <br />Value ofProiect <br /> <br />$ I I <br /> <br />Places of Assembly - Annual <br /> <br />B <br />B <br />B <br /> <br />Recreational Bum <br />Sparlders <br />Sprinkler System Installations <br />Standpipes ( Sprin1der System ) <br />Torch Roofing <br />Waste Tire Storage Annual <br /> <br />Other: I <br /> <br />Contractor Sign <br /> <br />Company <br />Registered <br /> <br />y <br /> <br />Address <br /> <br />N I Fee Current I <br /> <br />Electrician Sign. <br /> <br />License <br />Company <br /> <br />Registered <br /> <br />Address <br /> <br />y <br /> <br />N I Fee Current I <br /> <br />Plumber Sign <br /> <br />License <br /> <br />Address <br /> <br />Company <br /> <br />Mechanical <br /> <br />N I Fee Current I <br /> <br />Registered <br /> <br />y <br /> <br />Address <br /> <br />License <br /> <br />Other Sign <br />Address <br /> <br /> <br />Company <br />Registered <br /> <br /> <br />18330 Lawrence Rd. Dade City, FI <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 work 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 />502552000220004 <br />