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<br />City of Zephvrhills Fire <br />Permit Application <br /> <br />Date Received <br /> <br />4/4/200R <br /> <br />Contact Phone Nbr <br /> <br />Vi2-424-090o <br /> <br />I Pin Chasers <br />Owner Adldress . <br /> <br />Fee Simple Title Holder <br /> <br />Owner Phone <br /> <br />I Rl1 <br /> <br />II 7R2 <br /> <br />II '1'111 <br /> <br />Owner Name <br /> <br />I Titleholder Phone Nbr <br /> <br />II <br /> <br />II <br /> <br />Fee Simple Titleholder Address <br /> <br /> <br />Job Addre,ss <br /> <br />6816 Gall Blvd. Zephyrhills, FI <br /> <br />Sprinkler <br />Fire Alarm <br />Hood Clean - Suppression <br />Fire alarm Installation <br /> <br />D <br />D <br />~ <br /> <br />Parcel ID <br />D Fumigation Tent ----_.~,._.- . <br />D Hazardous Material <br />D Hood Installation -1111{)g <br />D LP - Natural Gas Installation <br />D -_..-- <br />D Places of Assembly - Annual <br />B Recreational Burn <br />Sparklers <br />B Sprinkler System Installations Value of Project I <br />Standpipes ( Sprinkler System) $ I <br />B Torch Roofing <br />Waste Tire Storage Annual <br /> <br /> <br /> <br />Subdivision <br /> <br />n Bio.-Hazard Waste Storage - ANNUAL <br />D Comm Exhaust Kitchen Hood - Duct <br /> <br />D <br />D <br />D <br />D <br /> <br />Controlled Burn <br /> <br />Emergency Generator <30 KW <br /> <br />Emergency Generator> 30KW <br /> <br />Fir,e Protection Maintenance - Annual <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fire Pums <br /> <br />Fire Works <br /> <br />Flammable Application- Annual <br />Fuel Tanks <br /> <br />Other: I <br /> <br />Contractor Sign <br /> <br />Company <br /> <br />Address <br /> <br />Registered <br /> <br />y <br /> <br />N <br /> <br />I Fee Current I <br /> <br />Electrician Sign. <br /> <br />License <br />Company <br /> <br />Address <br /> <br />Registered <br /> <br />y <br /> <br />N <br /> <br />I Fee Current I <br /> <br />Plumber Sign <br /> <br />License <br /> <br />Address <br /> <br />Company <br /> <br />Mechanical <br /> <br />Registered <br /> <br />y <br /> <br />N <br /> <br />I Fee Current I <br /> <br />Address <br /> <br />License <br /> <br />/c:..g~ <br />- <br /> <br />Other Si~ln <br /> <br />Company <br /> <br />License <br /> <br /> <br />Address <br /> <br />18330 Lawrence Rd. Dade City, FI <br /> <br />Registered <br /> <br />Directions: <br />Fill out application completely. Company <br />Owner & Contractor sign back of application, notorize ( Or signed <br />Copy of contract with owner) Registered <br />If over $2500.00, a Notice of Commencement is required <br />MechaniGal work of ( $5000.00 ) requires a Notice of Commencent <br />Supply two (2) sets of drawings with applicable documentation <br />Allow 10 - 14 days for review after submittal date. <br /> <br />502552000220004 <br />