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<br />813-780-0020 <br /> <br />Date Iieceived~ <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />City of Zephyr hills Fire <br />Permit Application <br /> <br />--f- ~1V~ <br /> <br />Fax-813-780-0021 <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br /> <br /> <br />Phone Contact for Pennit <br /> <br />7Lfij!e, <br />I <br />I <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />I J <br /> <br />II <br /> <br />7 L/L/ & <br /> <br />~ II Glued. <br />I <br /> <br />t Uti I AII"t:U rKUIVI t"KUt"t:K I T I AA NU 11L.t:) <br />v <br /> <br />I Lot# <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />'I: T <br /> <br />-EI <br />D <br />D <br />D <br />D <br />[2f <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Contractor <br />Signature <br />Address <br /> <br />ELECTRiCIAN <br /> <br />Signature <br />Address I <br />PLUMBER I <br /> <br />I <br /> <br />Parcel # <br /> <br />i"'V"1WI <br /> <br />B FUJlligi:fliUII T..111 <br />D Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />D Places of Assembly-ANNUAL <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <br /> <br />Brc-Hazard Waste Storage - ANNUAL <br /> <br />Comm Exhaust Kitchen HoodlDuct <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br /> <br />. <br />Fire Protection Maintenance - AUU~~ . se"vu <br />Sprinkler D <br />Fire Alann D <br />Hood Clean/Suppression [::] <br />Fire Alann Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Valuation of Project <br /> <br />Other: <br /> <br />Company <br />Registered <br /> <br />.s, rr\ J J.e-IC' (',...,. & ra ~ i-'l <br />Y I N Fee Current I Y I N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Fee Current I Y I N <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANIC4 <br />Signature ' <br /> <br />Address I <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y I N Fee Current Y I N I <br /> <br />I <br /> <br />Y / N I Fee Current Y / N I <br />I <br /> <br />Y I N Fee Current Y I N I <br />L <br />.~. '.-~ ...,...~~= ~ "~',='-~~~"__"W~' _'~ <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />OTHER <br />Signature <br />Address I <br />Directions: <br /> <br />Company <br />Registered <br />License # <br /> <br />.....,;;,"','"""'...-A . <br /> <br />.~~=. =<-=... <br /> <br />Fill out application completely, <br />Owner & COntractor sigh 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, <br />