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<br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Contact Phone Nbr <br /> <br />if'1Qov <br /> <br />I 352-424-0906 <br /> <br />I <br />I <br /> <br />Ilate Recei~ed <br /> <br />I 5/6/200R <br /> <br />Owner Name <br /> <br />Dairy Queen <br /> <br />Owner Phone <br /> <br />Owner Address <br /> <br />37930 Medical Arts Court <br /> <br />I RB <br /> <br />I I 7RO I I 2R26 <br /> <br />Fee Simple Title Holder <br /> <br />I Titleholder Phone Nbr <br /> <br />II <br /> <br />II <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />37930 Medical Arts Court Zephyrhills, FI <br /> <br /> <br />Subdivision <br /> <br />Parcel ID <br /> <br />Fumigation Tent <br /> <br />n Bio-Hazard Waste Storage - ANNUAL <br />D Comm Exhaust Kitchen Hood - Duct <br />D Controlled Bum <br />D Emergency Generator <30 KW <br />D Emergency Generator> 30KW <br />D Fire Protection Maintenance - Annual <br /> <br /> Qtrly Semi Anul Other <br /> Sprinkler <br /> Fire Alarm D D ~ D D <br /> Hood Cleaning IZr D D D <br /> Hood Suppression D D D D D <br />D Fire alarm Installation D D D D D <br />0 Fire Pumps <br />0 Fire Works <br />0 Flammable Application - Annual <br />D Fuel Tanks <br />0 Other: I <br /> <br />D <br />o <br />o <br />o <br /> <br />Hazardous Material (Tier" or RQ Facility) Annual <br />Hood Installation <br /> <br />LP - Natural Gas Installation <br /> <br />B <br />D <br />D <br /> <br />LP - Natural Gas Annual Sale <br /> <br />Places of Assembly - Annual <br /> <br />Recreational Bun <br />Sparklers <br /> <br />Sprinkler System Installations <br />o Standpipes ( Sprinkler System) <br />D Torch Roofing <br />U Waste Tire Storage Annual <br />Valuation $1 <br /> <br />Contractor Sign Company <br />Address Registered <br />Electrician Sign, License <br /> Company <br />Address <br /> Registered <br />Plumber Sign License <br />Address Company <br />Mechanical Registered <br />Address License <br />Other Sign Company <br />Address Registered <br /> License <br /> <br /> <br />Directions: <br />Fill out application completely, Company <br />Owner & Contractor sign back of application, notorize ( Or signed <br />Copy of contract with owner) Registered <br />If over $2500.00, a Notice of Commencement is required <br />Mechanical work of ( $5000,00 ) requires a Notice of Commencent <br />Supply two (2) sets of drawings with applicable documentation <br />Allow 10 - 14 days for review after submittal <br /> <br />Y N I Fee Current I <br /> <br />Y N I Fee Current I <br /> <br />Y N I Fee Current I <br /> <br />Y <br /> <br />N I Fee Current I <br /> <br />I <br /> <br />Security Fire Equipment, LLC <br />Y N I Fee Current <br />502552000220004 <br />