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<br />813-780-0020 City of .zephyr hills Fire }J 11' ,eFaX-813-780-0021
<br /># Permit Application 'ft
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<br />~!~rrlr~nowner'sPhoneNumber I~l~ 111~~ II ~dOO
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<br />Owner's Name
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<br />Owner's Address
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<br />I~ A.o.J.cnco
<br />1/30 J E:tQJ J '~LJ ~0o..m
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<br />I Titleholder Phone Number I
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<br />Fee Simple Titleholder Name
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<br />Fee Simple Titleholder Address I
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<br />Sub Division
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<br />I Lot#
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<br />Bio-Hazard Waste Storage - ANNUAL
<br />Comm Exhaust Kitchen Hood/Duct
<br />Controlled Bum
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<br />Emergency Generator < 30 kw
<br />Emergency Generator> 30 kw
<br />Fire Protection Maintenance - ANNUAL
<br />Sprinkler ~
<br />Fire Alarm
<br />Hood Clean/Suppression
<br />Fire Alarm Installation
<br />Fire Pumps
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<br />Fire Works
<br />Flammable Application- ANNUAL
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<br />Fuel Tanks
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<br />Parcel #
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<br />o Fumigation Tent
<br />D Hazardous Material (Tier II or RQ Facility) ANNUAL
<br />o Hood Installation
<br />o LP/Natural Gas-Installation
<br />D LP/Natural Gas-ANNUAL Sale
<br />D ' Places of Assembly-ANNUAL
<br />D Recreational Bum
<br />D Sparklers
<br />D Sprinkler System Installations
<br />o Standpipes (Sprinkler Sys)
<br />o Torch Roofing
<br />o Waste Tire Storage ANNUAL
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<br />Other:
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<br />Valuation of Project
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<br />Contractor
<br />Signature
<br />Address
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<br />Signature
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<br />DIrections:
<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.
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<br />ELECTRICIAN
<br />Signature
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<br />Address I
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<br />PLUMBER
<br />Signature
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<br />Address I
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<br />MECHANICALI
<br />Signature
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<br />Address I
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<br />OTHER
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<br />co~pany I'S~UCUhl (I~U.rn!~-C S,LAstct11 <)
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<br />Registered Y I N Fee Current Y I N I
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<br />License # I I
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<br />I Y/N
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<br />License # I
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<br />Company I
<br />Registered Y I N
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<br />License # I
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<br />Company I
<br />Registered Y I N
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<br />Company
<br />Registered
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<br />Fee Current
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<br />Y/N
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