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<br />Date Received <br />~1iI! <br /> <br />- Owner's Name <br /> <br />Owner's Address <br /> <br />Sub Division <br /> <br />7~(( <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020.. <br /> <br />City of.Zephyrhills Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br /> <br />~~);i~:i~'(f~'~~Z'l<-"..t.r"~~~~ <br /> <br />II <br /> <br />II <br /> <br />~~er's Phone Number <br /> <br />: ~0rl:-qa[J~':;J <br /> <br />II <br /> <br />II <br /> <br />I Titleholder Phone Number I <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br />m~:::~.-~T~~;-~--G ~ il <br /> <br />~\ \J u <br /> <br />i .....4181 <br /> <br />f.1~~~"..<,.,,,....~U-i~~~!,\l,,",,,,,,,,,..-~-~,n <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br /> <br />ELECTRICIAN <br /> <br />Signature <br /> <br />Address <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Address <br /> <br />MECHANICALI <br />Signature , <br /> <br />Address I <br /> <br />OTHER <br /> <br />Signature <br /> <br />Address <br /> <br />Directions: <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />D <br />D <br />D <br />D <br />D <br />Q <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />Sprinkler D <br />Fire Alarm D <br />Hood Clean/Suppression D <br />Fire Alarm Installation <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />~iiO" <br /> <br />Parcel # <br /> <br />~; <br /> <br />_~~~"L...~~i.-m <br /> <br />I Lot# <br /> <br />t utj I AII\lt::U rKUIVI t"KUt"t:K I Y I AA I\lU Ilvt::) <br />~~'i1 .l~_ fmt'- ~i~.....A~~ <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL .. <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />If If i ~lt."'~. -, <br /> <br />1iml'1>Il1l7"'iW"W- <br /> <br />-"-Wf" ""'" ~j;l" <br /> <br />Tt <br /> <br />....:;, L T ~ <br /> <br />~ <br /> <br />Other: <br /> <br />tjltuk <br /> <br />3 <br />'Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # <br /> <br />() one_-,'~-- <br />Y I N Fee Current <br /> <br />Y/N <br /> <br />D <br />D <br />D <br />o <br />o <br />D <br /> <br />-"""" <br /> <br /> <br />~_on' ! <br />Signature <br />Address <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <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 />