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<br />813-780-0020 <br /> <br />Date Received <br /> <br />OWner's Name <br /> <br />OWner's Address <br /> <br />-'5 ~-c.'::J'/:r <br />Ch di \~ &-fr(1 <br /> <br />City of.Zephyrhills Fire ...,{,.1 c1Q <br />Permit Application :rr 0 <br /> <br />Phone Contact for Permit <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br />I <br />I <br />17h~l3 <br />I <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />/I <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />.-u <br />D <br />D <br />D <br />D <br />D <br /> <br />D <br />o <br />o <br />D <br />o <br />o <br /> <br />I Lot# <br /> <br />?uti /31. <br /> <br />I <br /> <br />Parcel # <br /> <br />tutj, AINt:U r-KUIVl t'KUt'!:K I Y I PIA ''\IU I Iv!:) <br /> <br />B FumiYClliullT"lll <br />D Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/NaturaJ 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 />n <br /> <br />!:SIc-Hazard Waste Storage - ANNUAL <br /> <br />Comm Exhaust Kitchen HoodlDuct <br /> <br />Controlled Bum <br /> <br />. Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance ~ <br />Sprinkler 0' <br />Fire Alarm D <br />Hood Clean/Suppression D <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />I .1 Valuation of Project <br /> <br /> <br />Other: <br /> <br />Contractor Company I <br />Signature Registered <br />Address I Lf7t:J( CJC"l.k.. ~r ~(~ f2I... ''''''i Ucense # I <br />ELECTRICIAN I Company I <br />Signature I Registered <br />Address I , License # <br />PLUMBER I Company <br />Signature Registered <br />Address I I License # <br />MECHANIC1 I Company I <br />Signature . Registered <br />Address I , Ucense # I <br />OTHER I Company I <br />Signature Registered <br />Address I I Ucense # , <br />Directions: <br /> <br />~r~((J''V 67lnE<eJf <br />Y I N r Fee Current Y I N <br /> <br />Y I N I Fee Current Y I N <br /> <br />Y/N I Fee Current I Y/N I <br />I <br /> <br />Y/N I Fee Current I Y/N I <br />, <br /> <br />Y/N I Fee Current Y/N I <br />I <br /> <br />All out application completely. <br />OWilel'&ContractorsigfioaCk .of application,-nOfariZeo{0t."copy-6fs;gnecr cohtrcictWitfi OWher) <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 />