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<br />!;;~::;'=~_h-.J"~""~_j.=_J. Ill. "" _ Pho~e Contact fur Permit ~~RJJk2~.J;J <br />~8=~~ ll~~'_rlfl\~cm&t~Ph~'Nombw! II <br />Owner's Address . ---=~ --.: _ 9 (J rt _' C Vf2il1 CJ2 ,R ; '33?J){p <br /> <br />Fee Simple Titleholder Name I I Titleholder Pho~e Number I II <br /> <br />=~~ L ._ <br />Job Address 1/<61 3 ,533 ~cd I Bud. <br />I I <br /> <br />813~780-0020 <br /> <br />if 1i7f6 <br /> <br />City of Zephyr hills Fire <br />Permit Application <br /> <br />Ow,,"r'~ ~Iamlii <br /> <br />Sub Division <br />~i! <br />o <br />o <br />o <br />D <br />D <br />D <br /> <br />!Ii""" <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~~~ <br />~ !It" 0 0 L-J <br />OoooL:J <br />OoooL:J <br />OoooL:J <br /> <br />Sprinkler <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />Contractor <br /> <br />Signature <br /> <br />Address <br /> <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />ELECTRICIAN <br /> <br />Signature <br />Address I <br />PLUMBER I <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address <br /> <br />Parcel # <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 />Fax-813-780-0021 <br /> <br />II <br /> <br />II <br /> <br />j ,'_~TI'"M_lImW&._iW!: <br /> <br />I I <br />I <br />~ <br /> <br />"!', Lot# <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II 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 />{Jr\~ <br />/i~ <br />~ <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />License # <br /> <br />Valuation of Project <br /> <br />~~:C~lr\~tfl <br /> <br />14(0 Ys'<<.f &WOO II 'l~ I <br /> <br />I Y I N I Fee Current Y I N I <br />I I <br /> <br />I Y I N Fee Current Y I N I <br />I I <br /> <br />I Y I N I Fee Current <br />I <br /> <br />I Y I N I Fee Current <br /> <br />'~0L'~>i1 <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 />Company <br />Registered <br /> <br />Y/N <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 .(Mechanlcal 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 />