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<br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />City of.Zephyrhills Fire <br />Permit Application <br /> <br />Phone Contact for Permit <br /> <br />Fax-813-780-0021 <br /> <br /> <br />'';}''1fl <br />I J <br /> <br />Owner's Phone Number <br /> <br />I <br />I <br />I 38as-o <br />I <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />II <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />Cltil_ <br /> <br />------EJ <br />D <br />D <br />D <br />D <br />D <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />- <br /> <br />I Lot# <br /> <br />.A A\lt" <br /> <br />Zepb1"hdl5 1 FL. <br /> <br />I Parcel # I <br /> <br />33S'-l1 <br /> <br />{UIj I AINt:U rKUIVI t"KUt"t:K I Y I AA NU 111.t:) <br />- <br /> <br />B <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />tllQ-f1azard Waste Storage - ANNUAL <br /> <br />FUlIIiYi:lliUII T ..lit <br /> <br />Comm Exhaust Kitchen HoodlDuct <br /> <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 />Controlled Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - AHI~u~ CUoti-ltI/1 <br />Sprinkler 0" V <br />Fire Alarm D <br />Hood Clean/Suppression D <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Recreational Bum <br /> <br />Fuel Tanks <br /> <br />., Valuation of Project <br /> <br /> <br />Other: <br /> <br />Contractor Company I <br />Signature Registered <br />Address I Lf7()( CJe& k.. Pt::-~r Bot. -r~ PI- ., ""It License # I <br />ELECTRICIAN I Company I <br />Signature I Registered <br />Address I , License # I <br />PLUMBER I Company / <br />Signature Registered <br />Address I I License # I <br />MECHANIC4 I Company I <br />Signature . Registered <br />Address I I License # I <br />OTHER I Company I <br />Signature Registered <br />Address I ,,~..,.-. I License # I <br />~ .... E..... _.~.~,.~,... . <br />Directions: <br /> <br />"Sj rn-O I.,.,. 6-'", nflo.{! If <br />Y I N r Fee Current I Y I N <br /> <br />Y 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 I Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />'"""'v'~._~ _...~ n.' <br /> <br />Fill out application completely. <br />OWner & Contractor sigh back of application,notaiized (Or, ccipy 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 />