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<br />City OfZ~phyrhi/ls Fire <br /> <br />'Permit ~pplication <br /> <br />D t Received r-! Phone.' Contact fo.r permit-:I-"" ~. <br />l~~~""_""''''''''''''l''''''''''''~ R.J1..lIIl---" 'lOll"! T IOlliIIt--~A. fill ~II'I""""'T -:!!:,; ~-- <br /> <br />l~ ( \ b \ \10 La nO =r ~~T I Owner's Phone Number <br />Owner's Address Ib50fui\~r K22~~ <br /> <br /> <br />,,, ~m,I' TItl,h.." N,m. . I _ .. - - _ lTltloh.." Ph,,,, N=,,", <br /> <br />I ' <br /> <br />~ -1l..w l7! .mn ".-~~ <br /> <br />\.o(j~() <br /> <br />~':I -, i-; 1-; ,=. <br /> <br />813,780-0020 <br /> <br />Owner's Name <br /> <br />'~'H-~. <br /> <br />~~ S3 <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />Fee SImple Titleholder Address <br /> <br />~P"""'''''''!f." ,1 <br /> <br />I <br />I <br /> <br />, Job Address, <br /> <br />Sub Division <br /> <br />I <br />1m I <br /> <br />b\~ <br /> <br /> <br />]"! parcel# <br />J <br />111lll~~\1N <br /> <br />10 <br /> <br />I ~. j . Hood Installation <br />D lP/Natural Gas.lnstalla~lon <br />D LP/N&tural. G..s-ANNUAL' Sale. <br />o Places of Assembly-ANNUAL <br />D Recrl;latlonal Bum <br />. D SparKlers ' <br />. D Sprinkler System Installations <br />o <br />o <br />. . . j D W."" TUe -go ANNUAL <br />I <br />I <br /> <br />Cx~\\ . <br />" " <br /> <br />J.~':-'!fliMD.J\!l.U~ <br /> <br />"" nl <br /> <br />.,. <br /> <br />~. <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />o <br />o <br />D <br />o <br />D <br />D <br /> <br />Bio-Hazard Wa>;te Storage - ANNUAL. ' <br />Gomm Exhaust Kitchen Hood/Duct. <br />Controlled Bum <br /> <br />Emergency Generator < 3Q.kw <br />Emergency Generator" 30 kw <br />Fire Protection Maintenance - ANNUAL <br /> <br />Sprinkler <br />Fire Alarm <br /> <br />5 <br />D <br />D <br /> <br />H <br /> <br />H <br />,\!:'I <br />-,\", <br /> <br />'ll ~ <br />'J j j- <br /> <br />D-CiJ~, <br /> <br />I:;;'"" <br />.I., ~ ~ ..... <br /> <br />Hood Glean/Suppression. <br />Fire Alarm Imrtallatlon <br /> <br />Fire Pumps <br /> <br />Fire Work>; <br /> <br />Flammable Appllca~lon- ANNUAL. <br /> <br />Fuel Tanks <br /> <br />f=ax.813~780.0021 <br /> <br />ll'T""" "" "",~",..,.,...;.J ' <br /> <br />II I J - I <br />: <br /> <br />I <br /> <br />I J <br /> <br />II <br /> <br />II!I~ <br /> <br />_.~!11 rf .u: UJIHI <br /> <br />I Lot # ," I I <br />.fq,Q- Q ~; J ~QQ 1'~~~cZtO-(XJQi <br /> <br />1;\ IAIN~U I- UM PK IY AX. U 11(,:1=)' <br />. ~m " ~. 'Wi n L '""' " 11ll-1IIIIIlJ:1iI_?,"''''''~ <br /> <br />'j WilJqJ <br /> <br />118 <br /> <br />Fumigation Tent . . " . <br />Hazardous Material (Tier II or R.aF~cill~) ANNUAL. <br /> <br /> <br />Standpipes (Sprinkler $Ys) <br />. Torch Roofing <br /> <br />r <br /> <br />Valui3tlon of Project <br /> <br />Other: <br /> <br />OTHER <br />Signature <br /> <br /> <br /> I Company I <br /> Registered <br /> II Ucense # I <br /> i I, Company I <br /> Regiatered <br /> !I License # I <br /> I I I <br /> company, <br /> I Registered, <br /> : I Ucense iF I <br />'! 1/ Company I <br />I I Registered <br /> Ucense # <br /> Comoany <br /> Registerl;ld <br /> Ucensa <# <br /> <br />Contractor <br />Signaturo <br /> <br />Address I <br /> <br />ELECTRICIANI <br />Signature . <br /> <br />Address I <br /> <br />PLUMBER I <br />Signature I <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature I <br /> <br />Address I <br /> <br />i\ddrese <br />"DlreCtions, <br /> <br />Y/N I Fee Current Y/N I <br /> I <br />Y / N I Fee Current Y/N I <br /> I <br /> <br />YIN <br /> <br />Y / N j <br />I <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />YfN <br /> <br />Fee Current <br /> <br /> <br />E"iil out application cGmplerelV, <br />Owner & Contractor 51gn baCK or application, notarized (Or, copy cf signed contrec, with ownen <br />If over $2500, a Notice of Commencement i5 required (Mecnanipal worK over $5000) <br />SUPply two ~2-' ~e!~ cf ;jra\v!ng~ lNith applicaole documentation -; <br />Allow 'jQ.'j<1- days for review after submittal date. ' <br />