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<br />8'13-7~0-0020 City of Zephyr hills Fire !/' 11 '51 Fax-813-780-0021 <br />- j ) Permit Application . c._ <br /> <br />h~:i::e~~;~:!@wftw_L""~~~~!,..@_,,,,,,,~.L--_--:~~tact~::~~,jL~w@.~.JU,!t~~JJ.~!q~.~.I <br />I Own~~sPhoneNumberI9/3 117~Z 11'i9CX5 I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br /> <br />gs; <br />I <br /> <br /> <br />~l;__" <br /> <br />385/$ C':/l. 5 c..{ / G <.-Jt-I D <br /> <br />I <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />I Titleholder Phone Number I <br /> <br />lZ .1'1. ~+ <br />I Parcel # <br /> <br />II <br /> <br />II <br /> <br />Lot # <br /> <br />Contractor <br />Signature <br />Address I <br />ELECTRICIANI <br />Signature . <br />Address I <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALl <br />Signature . <br />Address I <br />OTHER <br />Signature <br />Address <br /> <br />~ <br /> <br />D <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-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 DOL--' <br />Fire Alarm 0 0 0 0 c=J <br />Hood Cleaning 0 0 0 0 c=J <br />Hood Suppression 0 0 0 0 c=J <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br />Fuel Tanks <br /> <br />D Fumigation Tent <br />D Hazardous Material (Tier" or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />I::2SI Places of Assembly-ANNUAL <br /> <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch RoofinglTar Kettle <br />D Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Other: <br /> <br />L&i <br /> <br />-'Va """""=."""""" ~::i1.1~HW~ <br /> <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />q. u/~,r <br />I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N Fee Current <br /> <br />Y/N <br /> <br />Directions: <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 />