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<br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />17fcf8 <br /> <br />City of Zephyr hills Fire <br />Permit Application <br /> <br /> <br />FJ Z 1- <br />I <br />I <br />1.73 2. 7- <br />I <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />C/rl..l- <br /> <br />#t. V II <br /> <br />Fax-813-780-0021 <br /> <br /> <br />I ,,:s <br /> <br />117r1111~~ <br /> <br />II <br /> <br />II <br /> <br />I Lot# <br /> <br />Parcel # <br /> <br />D Fire Alarm Installation <br /> <br />D <br />D <br /> <br />B Fuel Tanks <br />D Other: I <br /> <br />I~~ <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIANI <br />Signature . <br /> <br />Address I <br /> <br />PLUMBER I <br /> <br />D- Bio-Hazard Waste Storage - ~NNU_~=--__ <br />~"1!xhatI~oR Heod,l3uet <br />D Controlled Bum <br />D <br />D <br />D <br /> <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 />Doooc=J <br />I3QI lp> 0 0 c=J <br />Doooc=J <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Appllcation- ANNUAL <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier /I 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 /> <br />IJl'~ (/ C{6. <br />Standpipes (Sprinkler Sys) j) 1)1<- ftl <br /> <br />Torch RoofinglTar Kettle f1T i) rI _. ,; <br />Waste Tire Storage ANNUAL ~M (~ <br /> <br />Valuation of prciJt <br /> <br />Sprinkler System Installations <br /> <br />Signature <br />Address I <br />MECHANICALI <br />Signature <br />Address I <br /> <br />OTHER <br />Signature <br />Address <br /> <br />Company I fiJf =ttS r C.W 17:ri1 <br />Registered Y V N Fee Current I ~ N <br />License # I I <br />Company I <br />Registered Y/N Fee Current Y/N I <br />License # I I <br />Company I <br />Registered Y/N Fee Current Y/N I <br />License # I I <br />Company I <br />Registered Y/N Fee Current Y/N <br />License # I <br />Company I <br />Registered Y/N Fee Current Y/N <br />License # <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 />