Laserfiche WebLink
<br />813-780-0020 <br /> <br />r;~:te Rewved <br /> <br />OWner's Name <br /> <br />OWner's Address <br /> <br />J d-{~~I- <br />I ;Zep^y r Aft! ~ <br />I <br /> <br />HOof" <br /> <br />l4 ~t3 <br /> <br />Phone Contact for Permit 1~~._ ~U~?~ U~:J <br />I II II <br /> <br />City of.ZephyrhiJIs Fire <br />Permit Application <br /> <br />:7id,~1 <br /> <br />Fax-813-780-0021 <br /> <br />OWner's Phone Number <br /> <br />( <br /> <br />Fee Simple Titleholder Name <br /> <br />II <br /> <br />I <br />I <br />139/00 <br />I <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />- <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />--u <br />o <br />o <br />o <br />o <br />o <br /> <br />o <br />D <br />o <br />D <br />D <br />D <br /> <br />Contractor <br />Signature <br />Address <br /> <br />~ <br /> <br />4~ <br />I <br /> <br />Parcel # <br /> <br />ilr~ <br /> <br />rr1 <br /> <br />I Lot# <br /> <br />I (~~... 2---\-0 {()O- DC>OOO-007o <br />\Ut:SIAINl::U rKUIVI t"KUt"l::KI Y I~ l'IUIIL.l::) <br /> <br />... <br /> <br />B FUllliycdiulI T tllIL <br />D Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />D Places of Assembly-ANNUAL <br />D Re~eationalBum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br /> Company <br /> Registered <br /> License # <br /> I Company <br /> Registered <br /> I License # <br /> I Company <br /> Registered <br />I License # <br />I Company <br />Registered <br />I License # <br />I Company <br /> Registered <br />I License # <br /> <br /> <br />ELECTRICIAN <br />Signature I <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICA4 <br />Signature I <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address I <br /> <br />Directions: <br /> <br />tile-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen HoodlDuct <br /> <br />Controlled Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenanc~ <br />Sprinkler 0 <br />Fire Alarm ~ <br />Hood Clean/Suppression D <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />n,. <br /> <br />- <br /> <br />'::5'~ 6-I-,nD[ <br />Y I N Fee Current Y I N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y IN I <br />I <br /> <br />I <br />I <br /> <br />, <br />J <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N Fee Current <br /> <br />Y/N <br /> <br />.~ ~ <br /> <br />(~...O <br /> <br />Fill out application completely. <br />Owner & Contractor sigh baclCof application, notarized (Or, copy Of sighed 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 1 0-14 days for review after submittal date. <br />