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<br />City of Zephyrhi/ls Fire <br />Permit Application <br /> <br />Date Recei~ed I I Phone Contact for pennltll J <br />Mf~~~.,...s$_~rtWiI~B;~'~'1$~~~~m~~~~~;!iJ . 1}l~io~~..._'~"- <br /> <br />Owner's Name TERRY ANDERSON / ANDERSON PRESSU~E cm.Ji!tA;lffl~ Number I 813 II <br /> <br />813-780-0020 <br /> <br />Owner's Address <br /> <br />~ 1Bt~ <br /> <br />Fax-813-780-0021 <br /> <br />II I <br />'''''...'''<ti.........,'',..:ilioo:;v'''~~,.-; <br /> <br />884 I 15208 I <br />I <br />"1 I <br />I <br /> <br />5104 M[JRRAY HILL DR.TAMPA,FL.33615 <br />I Titleholder Phone Number <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />II <br /> <br />Job Address <br /> <br />Z&r'_~~~~"",~""""'~T;m~A!v.~~~~mm~*~Jim ~,:>dk~~~Y.ar~Jll!~~;~~~arg~14"mi$] <br /> <br />Sub Division <br /> <br />GOWEN CORRAL 6855 <br /> <br />I Lot# <br /> <br />GALL BLVD. ,ZF.PHYRHTT.T,S, FT, iil)b?-?57h <br />I Parcel # I <br /> <br />~~~~~-~ ~~ii~llmm'-~Mli. <br /> <br />",--..>o:lf"~""" <br /> <br />D <br />[XX] <br />D <br />D <br />D <br />D <br /> <br />D <br />D <br />D <br />D <br />o <br />D <br /> <br />~"""""""'I'lIIII.' <br /> <br />Contrrc~r., ~. L-...." <br />Signature L <br /> <br />Address I <br /> <br />ELECTRICIANI <br />Signature , <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br /> <br />Signature , <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br /> <br />l~wia!~~l"'_'~'._I" <br />Directions: <br /> <br />~I&llfi v <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct 3/i f I cC <br />Controlled Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br /> <br />Sprinkler <br />Fire Alann <br /> <br />D <br />D <br />o <br /> <br />Hood Clean/Suppression <br />Fire Alann Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br />Other: I <br /> <br />-,~~ <br /> <br />~llll!~l...~m,':mil-.l~"" <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 />(Uti I AINl=U I-KUM t-'KUt-'l=K I Y I AX NU 11l,;t:) <br />- -- r "'~:K ?"I'~"""",,..a."~-g:J;f'MM~~: <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />1m!' Tf.)[ <br /> <br />I! iJ <br /> <br />I <br /> <br />.ll...~~, <br /> <br />I <br /> <br />.. <br /> <br />.... --h -,'" <br />-,~ ~-, J <br /> <br />.,-,r,.,,\1 <br />)...'.... ~ 'r~ " <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />... . <br />., <br /> <br />, ~ ,-e~\-..~ '. <br /> <br />": <br /> <br />:'. <br /> <br />.. <br /> <br />, "':~M"""''i:!'i':ill~'''''''-'''''''-''"'''''''''~ <br /> <br />"",,;.'t1\~"""'^n:&"""'" ~w' <br /> <br />~'nI:lH!t! <br /> <br />f_. <br /> <br />.... <br /> <br />.~,,~ <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y I N I <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y IN I <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />I <br />lI~r'ii~~_'';''<F'''''lrr~''~ <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. <br />