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<br />/14/_'iJ'(iE[ W':'J Fr,~ ZEPEYRHILS B'JiLl)J["lG <br /> <br />: ,~.Z N ':'. ~I: '::-. <br /> <br />813-780-0020 <br /> <br />City ofZephyrhllls Fire <br />Permit Applic!rtion <br /> <br />Date Received ...b 3 - .;)(J' 0 L : ::-:1.... Phone contact for PelTl1lt <br /> <br />:..", N,m:" ~~~:~~:~r. ,. J o.n." ~'N":b. <br /> <br />. -:- -. <br />CMner'5 Addr~15 ~033 Middle 'Av;nue, Zephyrhills, FL 33542 , <br /> <br />Fee Simple TitlGh9Id~ Name [- . ~ TItleholder phone Nl.rnber . [ <br /> <br />. FeeSlm~le T~der Addre$S.. .~ <br />-"".J [" A' ~ ..LT''''' L..T .-: - <br /> <br />JobAdd.~ . . 38033 .:~1iddle Aven'!e, Zephyrhills, FL 33542 <br /> <br />. S'Jb Oivision fWinters MRP' .1 Parcel # I <br /> <br />....Rl . _ II: 'L~.I.. ; ~I-="'" H-f 1 I .. U <br />.0 Ellf>"~ W~te Sto,a9o~ ANNUAL E3. Fumigation Tent <br /> <br />o . Comm ExtlllUst l<ltohen Hood/D'JOl 0 ~ous Matflllal.(T1er II Qr RQ FBoiI~) AN~--~ <br /> <br />ICSo .::::::.....,.,'" ~.::=O:::- .' (t. .. ..'Jt...r11 ~./......' . <br />Em~1'QilflC!( 3el'lSl'atcf ;> 30 k\'i, 0 LP/NatUra' Gs5-ANNUAL. Sale -::rf l & .. . <br />o Firil Proteotion Maintenance ~ ANNUAL 0 F"la= of Assembly-ANNUAL . ~ . <br />Sprinkler 0 D ReaeationaJ Bull <br />F"lTe.Alarm.D D 5parlders <br />Hood Cl..n/Suppre<>ill<;Jl': D 0 S!rtlldar System Installatlofl$ <br />.FlrG Alarm'lnlltillafion 0 standplpei;: (Sprinkltl' Sys) <br />FIre Pumps D Torch Rootlng <br />D Waste lire .$tprage ANNUAL . <br /> <br />I <br /> <br />- <br /> <br /> <br /> <br />~dress ~. .__,,__: _"~ ,,~..,...._~,~,_ _ <br />D~scftons: . <br />FIll ol,ll"ppllOllllon complet~)', . <br />Owner B. Contl'llt:tor, sign back of appliOEltior.,notarn:ed (Or, ooPY Qf'slgned controct wfth owner) <br />:f over $2500, i:I Noli~ of Commencement i5 roql.linild (M$el'1anlC!l1 \IIIQf\.: over $5000) . <br />SUpply two (2) sets of dl'l'.Min~6 with lilPplleable documenlEtion <br />Allow 10.14 day:! for relfil'w after ~ubln!ttal date. <br /> <br /> <br />FJre Works <br />Fllimmable App"~lIon- ANNUAL <br /> <br />Fuel Tank:5 <br /> <br />Other: <br /> <br />ConviI"br <br />Signature <br /> <br />Address <br /> <br />ELECTRICIAN- <br />Signature . L <br /> <br />Adclrfl$8 [ <br /> <br />p~UMaER .1 <br />SIgnature . <br />Addl'ElSs r <br />MECHANICAl.[ <br />Sigl1atIJre . . I <br />A(lc!ress I <br /> <br />OTHER I <br />Signature <br /> <br />l. <br />.J <br />.~ <br />.-J <br />J <br />I <br />. ] <br />.~_~, <br /> <br />';Ai' <br /> <br />Company <br />Registered <br /> <br />Ucense f# <br /> <br />. Company <br />ReglstereCl <br /> <br />Ucen:le # <br /> <br />Company <br />Registered <br /> <br />Lic8Mfl # <br /> <br />. CompelnV <br />. Raglstere:l <br /> <br />UcenSB #- <br /> <br />COmpany <br />Registered <br /> <br />Ucense IF <br />1--.,........ <br /> <br />,I '.'1 <br /> <br />~ i, ~ 1 <br /> <br />Fax~13-7eO-0021 <br /> <br />'.1_ 35~r"n~L.567 ,~3~~ 4 <br />I 813 . II 780 '1 [1874 <br /> <br />II <br /> <br />j I <br /> <br />. : <br /> <br />- <br /> <br />IV <br />J I..JJt# <br /> <br />\utHAII~U t"KI,JMt'~~~l ~ I~vl M;/ = <br />t+ 1_ )111- '11- <br /> <br />I <br /> <br /> <br />d'/I/} J <br /> <br />'1 <br /> <br />Valuation <<;If Project <br /> <br />I <br />1 BOl.t:!-n Pest Control . <br />. Y / N "I FeeClJlT$lll 'U I N <br />I J H44J <br /> <br />[~ I N J . -Fee Current 'I <br />I <br /> <br />l y / N r Fee current <br />-r <br /> <br />F <br />I <br /> <br />I Y/N <br />I <br />-lllIl <br /> <br />iliff... <br /> <br />Y IN] <br />I <br /> <br />Y IN I <br />I <br /> <br />.'~ .. <br />.y I N r Fee Current I <br /> <br />Y I N 'j <br />"j <br /> <br />FH Currentl <br /> <br />J1I ril~ ~ <br /> <br />Y I N I <br /> <br /> <br />IIUlrUlP:rI/ ,l <br /> <br />IT .". <br />