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<br />City of Zephyrhills Fire <br />Permit Application <br /> <br />~~~Y;~llVlmJi'~l.-""."_-...,,__,..,,,l-.ulmil!\5!!!!l~Ml'llar___~~~.~g)~~~~P~~W..,.~~2...JJ2!_",,_u.!21t;' <br />I 'g/3 II 1]80 11.f17~ I <br />PL 3~Jf/~ <br />TiUetlolder Phone Number I ~/3 II'lKO IlR77Y I <br /><Z~E~'-'_:'~~~ll1lHi;;;;-..iiiiiilIllj~2iffiijjllllIHl! <br />I Lol# I I <br /> <br />lVtlI I\INl:U ~t(VM PROPERTY lAX NUTlGI:} I <br />.. .. -- - llIIIIlflIlI&;Oi....=;~OlIl!illllllllllb'ii; <br /> <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simpl9 TiUenolder Name <br /> <br />r:=====--~~~~~~i~:.:~: <br /> <br />Job Address I V~ ~ '- <br /> <br />I <br /> <br />41~c{( <br /> <br />Fax-813-780-0021 <br /> <br />Parcel # <br /> <br />,ii~llIllt:l:e;:';.'\:r.IIlllIIlll~ <br />D Fumigetion Tenl <br />D Hazardous Material (fi9r II or RQ FlIcllily) ANNUAL <br />D Hood Instllllllllon <br />D LP/NlItural Gas-Installation <br />D L.PlNalural Gas-ANNUAL Sale <br />D Places or Assembly-ANNUAL <br />D Recre8~onal Surn <br />D Sparklers <br />D Sprinkler System Installations <br />D <br />D <br /> <br />D Wasl8lirG SIOI'8ge ANNUAL <br /> <br />_lflI3d! ""'O~'lf.-m;;............__..IlnIlInnn~_llll!llIIlll~1I111 lUtlo. __~!ffi'.!;r,l!~~Ullllll4lWi <br />Company fl2:oatu\ I1.rt. ~riQ.~ T~JL.~ I <br />Regislered rmNI Fee Current I YJ oN ( <br />LicenS91# ~ ZfX){J II q 'i q ... J'Stl&'i 1: i~~ <br /> <br />Company [ I <br />Registered l Y / N r Fee Currenl Y I N <br /> <br />License # I <br /> <br />Company I <br />Regislered <br /> <br />Licen~ #- I <br /> <br />~~~~::d I Y I N <br /> <br />License 1# r ~ <br /> <br />I I ~m~~ I <br />Signeture Registered Y I N I <br /> <br />!lllllll~~lI_lIl1"_'."'.'_'''''..'''''''..lI'm''''''''''.'.''''.'''''''''III'''''''''''"''',,",___'L~J~_"""".lI""" <br />Direclions: <br />Fill Olll application completely. <br />Owner &. Contrector lOign back Qf applicetion, notarized (Or. copy of signed contract wilh owner) <br />II' oller $2500. a Nolice of Commencement Is required (MechanICal work over $5000) <br />Supply two (2) sels of drawings with applicable documentation <br />Allow 10-14 days lor rel/iew after submittal date. <br /> <br />Sub Dil/ision <br /> <br />i;;a!~!lilllllUN.llli -- <br />D <br />D <br />D <br />o <br />D <br />~ <br /> <br />Bio-Hazard Wasle Storage. ANNUAL <br /> <br />Comm Exhaust Kitchen HoodlOuct <br /> <br />Controlled Burn <br /> <br />Emergency Generator <; 30 kw <br /> <br />Emergency Generalor > 30 kw <br />Fire Protection Malntenllnce - A~ <br />Sprinkler ~ <br />~ir9Ararm 0 <br />Hood Cleen/Suppression 0 <br /> <br /> <br />Fire Alarm Inslallation <br />Fire PUmps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br /> <br />Contractor <br />Slgnatl.lre <br /> <br />Address <br /> <br />ELECTRICIANI <br />Signalur9 . <br /> <br />Address I <br /> <br />PLUMBER <br />Signalure <br /> <br />Address I <br /> <br />M.ECHANICALI <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br /> <br />~ 'd <br /> <br />ono 'ON <br /> <br />Stllndpipes (Sprinkler Sys) <br />Torctl Roofing <br /> <br />Valuation of Project <br /> <br />Y/N I <br /> <br />- <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Fee Currenl <br /> <br />Y/N <br /> <br />Fee Current I Y I N I <br /> <br /> <br />"',.._......'.,~"....._~~~!$i'.J;;1!!~~ <br /> <br />JINIlJ lVJI03W VOI~Olj <br /> <br />~d9~:E 800~ 'El 'H~ <br />