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<br />B 13-7BO-00~0 <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 />$1~Cbh <br /> <br />Fax-B13-7BO-0021 <br /> <br /> <br />Phone Contact for Permit <br /> <br />I <br />117B8 117//41 I <br /> <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Titleholder Phone Number <br /> <br />II <br /> <br />II <br /> <br />Job Address <br /> <br />lf~0' <br /> <br />I Lot# <br /> <br />I <br /> <br />Parcel # <br /> <br />Sub Division <br /> <br />D <br />o <br />o <br />o <br />o <br />o <br /> <br />Bic-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~~~~ <br />Sprinkler 0 0 0 0 L--J <br /> <br />Fire Alarm ~ 0 0 ~ c=I <br /> <br />Hood Cleaning 0 0 0 0 c=I <br /> <br />Hood Suppression 0 0 0 0 c=I <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />o <br />o <br />o <br />o <br />o <br />o <br />D <br />D <br />D <br />D <br />o <br />o <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />[j) l'Ytd ' <br />?'lp'b/6~ <br /> <br />Valuation of Project <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br /> <br />Contractor If)/, I , I.L 1/1 /7.. - - ,. <br />Signature .~ <br /> <br />Address I r$~ I K~'/ !>Jnn;" d/! 7J:JJ(fW1 ~J?l1Jr!j {' F L <br />ELECTRICIAN <br />Signature <br />Address I <br /> <br />PLUMBER <br />Signature <br />Address I <br /> <br />MECHANICALI <br />Signature . <br />Address I <br /> <br />OTHER <br />Signature <br />Address <br />Directions: <br /> <br />~ <br /> <br />o <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 />Fee Current <br /> <br />Y/N <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. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />