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<br />I 813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />City of.Zephyrhills Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br />-/~~ ,;l~ <br />I Z<p~" j/<--- (7~~ <br /> <br />~ Owner's Phone Number <br /> <br />Fee Simple Titleholder Name <br /> <br />I Titleholder Phone Number I <br /> <br />I <br />I <br />1~38djL)A-~ 1J <br />I <br /> <br />lIRJi <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />u_ <br /> <br />--0 <br />D <br />D <br />D <br />D <br />D <br /> <br />c <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Parcel # <br /> <br />Ijlo-Hazard Waste Storage - ANNUAL <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br /> <br />:::~e"o" Ma;"~~"7~~UV <br /> <br />Fire Alarm .. .:::~<---~ <br />Hood Clean/Suppression D <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fax-813-780-0021 <br /> <br /> <br />~~ <br /> <br />II <br /> <br />II <br /> <br />II <br /> <br />II <br /> <br />I Lot# <br /> <br />\Vl) I AII'\ICU rt'(VIVI t"'t'(Vt"'Ct'( 1 Y I",^ I'\IV 11\.,,1;;) <br /> <br />EI l"ullliYi:diull Telll <br />o 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 RecreationalBum <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 />Fuel Tanks <br /> <br /> <br />Other: <br /> <br />Contractor Company <br />Signature Registered <br />Address License # <br />ELECTRICIAN Company <br />Signature I Registered <br />Address I License # <br />PLUMBER Company <br />Signature Registered <br />Address I License # <br />MECHANIC' Company <br />Signature . Registered <br />Address I License # <br />OTHER Company <br />Signature Registered <br />Address I License # <br />Directions: ..",;",A""",..,,'. .,=""'~== <br /> <br />~i <br /> <br /> <br />Valuation of Project <br /> <br />:S~Jr'afk;1e r ~.9f"'oe./ <br />Y I N Fee Current Y I N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y/N I <br /> <br />Fee Current <br /> <br />Y IN I <br />I <br /> <br />I <br />I <br /> <br />I <br />J <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N I <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />..= <br /> <br />'~'.' .,..',._..~'""'~''''"...,,"~ <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 documentation <br />Allow 10-14 days for review after submittal date. <br />