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<br />City of Zephyrhills Fire <br />Permit Application <br /> <br />!'~~~~'1::;'~'~~;~@}iW'~&WMJ;;,~jlZ!;21Qa.,;!m",,,,.1~i~__Wl1%__W;\~"'$"__M_Wl_(%f&XWk"~~~!~~~r:~~;:~~!tj~,,~~L~L;,,,~lxL2L["" <br />lilA. (~tt'\ rNTE)W Ire (alJ t\ L I Own~~s Phone Number I Boa <br />I 0~34 P7ftt t 7Lv/~ <br />I <br />I <br />63 <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br /> <br />V]) <br /> <br />~ 1611 <br /> <br />Fax-813-780-0021 <br /> <br />l);,L~L~N I <br />1101</<./ <br /> <br />I Titleholder Phone Number <br /> <br />II <br /> <br />II <br /> <br />Lot # <br /> <br />Parcel # <br /> <br />o <br />o <br />o <br />D <br />D <br />o <br /> <br /> <br />Contractor <br />Signature <br />Address <br />ELECTRICIANI <br />Signature , <br />Address I <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature . <br />Address I <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <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 /> <br />Fire Alarm 0 0 0 0 c=J <br /> <br />Hood Cleaning 0 0 0 0 c=J <br /> <br />Hood Suppression 0 0 0 0 c=J <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />ther:1 <br /> <br /> <br />~rJt <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />@ <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Instal/ation <br />LP/Natural Gas-Instal/ation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Instal/ations <br />Standpipes (Sprinkler Sys) <br />Torch RoofinglTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br /> <br />OTHER <br />Signature <br />Address <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Fee Current <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 (Mechanical work over $5000) <br />Supply two (2) sets of drawings with applicable documentation <br />AI/ow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />