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<br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fax-813-780-0021 <br /> <br />City of.Zephyrhills Fire <br />Permit Application <br />n." .;~~': ~~~~~:;,~i~J <br /> <br />""""l~"'/1 <br /> <br />F 6fL6kJ v.1-l <br /> <br />.sf <br /> <br />Fee Simple Titleholder Name <br /> <br />~,~.;=~~L..", n ,,,,.,.._--Lilf" <br />J B t3 LA <br />I 3> 4 0 I. W . IJ1I5S, A tL <br /> <br />''F= 1t <br /> <br />......--~IID. mi~ -......i~4~~1~%~~.7;W~~ <br /> <br />Fee Simple Titleholder Address <br /> <br />=:~--!-T;~::;~)' S <br /> <br />Sub Division <br /> <br />",..~>.!~-''''-'"''' <br />1)350 II Q350 <br /> <br />~"'r<;;;. <br /> <br />Owner's Phone Number <br /> <br />/gl.3 <br /> <br />II <br /> <br />II <br /> <br />I Titleholder Phone Number I <br /> <br />I Lot# <br /> <br />u 0 LJ;l.. GALL-- 8l..-U-f . <br /> <br />Parcel # <br /> <br />(UtjIAII\lt:U rKUIVI t-'KUt-'t:KI Y IAA I\lUII~t:) <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 />D <br /> <br />~~~ <br /> <br />Contractor <br />Signature <br />Address I <br />ELECTRICIAN <br />Signature I <br />Address I <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature .. <br />Address I <br />OTHER <br />Signature <br />, Address I <br />--."'><"" <br />Directions: <br /> <br />Bio-Hazard Waste Storage - ANNUAL <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 /> <br />Sprinkler <br />Fire Alarm <br /> <br />D <br />~ <br /> <br />D Fumigation Tent <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 />o Recreational Bum <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 />h fiF'~~-'1V <br /> <br />"nill <br /> <br />Valuation of Project <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />12- <br /> <br />r <br /> <br />Hood Clean/Suppression <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />-;-'-~~=<:';="~1l";i'>;;""',;,;;ili';';:'''''';';O''-.'''''~-~ "'. <br /> <br />"'''''''''iW'''''''''''''''-y'''-'''.,,'':<<.-m/.;<, <br /> <br />Company <br />Registered <br /> <br /> <br />""",-i"'-'_~~"_""ili.O:;';';"."'h''''U'''' <br /> <br />'"" ".W-'-~;';-'~' <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br />Registered <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br />Registered <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />L~~?= # .,1.. <br /> <br />'.l"'~."--".,,,,~,~-,,,,,,,__,,,,,,,,,...,.,,,,,l~_ <br /> <br />~';"';";."~IO<'~~<W <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 />