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<br />Date Received <br /> <br />4/4/200R <br /> <br />111111 <br /> <br />Owner Name I <br />"1_ Hollow MlIP <br />Owner Address . <br /> <br />Fee Simple Title Holder <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />-#'1101 <br /> <br />Contact Phone Nbr <br /> <br />l'i2-424-09Ofi <br /> <br />Owner Phone <br /> <br />I Rl1 <br /> <br />II 7R2 <br /> <br />I Titleholder Phone Nbr <br /> <br />II <br /> <br />II <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />38615 Lansing -54 W Zephyrhills, Fl <br /> <br /> <br />Subdivision <br /> <br />Parcel ID <br /> <br />Fumigation Tent <br /> <br />B Bio-Hazard Waste Storage- ANNUAL <br />Cornm Exhaust Kitchen Hood - Duct <br />0 Controlled Bum <br />0 Emergency Generator <30 KW <br />0 Emergency Generator> 30KW <br />D Fire Protection Maintenance - Annual <br /> Sprinkler D <br /> Fire Alarm 0 <br /> Hood Clean - Suppression ~ <br />D Fire alarm Installation <br />D Fire Pums <br />0 Fire Works <br />0 Flammable Application - Annual <br />0 Fuel Tanks <br />0 Other: I <br /> <br />o <br />o <br />D <br />D <br />o <br />o <br /> <br />Hazardous Material (Tier II or RQ Facility) Annual <br /> <br />Hood Installation <br /> <br />LP - Natural Gas Installation <br /> <br />LP - Natural Gas Annual Sale <br /> <br />Places of Assembly - Annual <br /> <br />B <br />B <br />B <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes ( Sprinkler System) <br />Torch Roofing <br />Waste Tire Storage Annual <br /> <br />Value of Project <br /> <br />$ I I <br /> <br />Contractor Sign Company <br />Address Registered <br />Electrician Sign. License <br /> Company <br />Address <br /> Registered <br />Plumber Sign License <br />Address Company <br />Mechanical Registered <br />Address License <br />Other Sign Company <br />Address Registered <br /> License <br /> <br /> <br />y <br /> <br />N <br /> <br />I Fee Current I <br /> <br />y <br /> <br />I Fee Current I <br /> <br />N <br /> <br />y <br /> <br />I Fee Current I <br /> <br />N <br /> <br />Y N <br /> <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 />Mechanical 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 />Security Fire Equipment, LLC <br /> <br /> <br />502552000220004 <br />