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<br />OCT/31/2007/WED 02: 18 PM <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />FAX No. 813-780-0/2 <br /> <br />City of.Zephyrhills Fire . .."19 S J <br />Permit Application <br /> <br />P. 002 <br /> <br />Fax-813-78D-0021 <br /> <br />813-780-0020 <br /> <br />Owner's Nama <br /> <br />5 eru: ~ VL <br />'^ t ( It /o/h;... <br /> <br /> <br />r1f ( 3l'17S52-I.I~1.f't2-1 <br /> <br /> <br />Date ReceIved <br /> <br /> <br />Phone Contact fur PermIt <br /> <br />Owner's Address <br /> <br />Fee Slmpl. ",.ho~" Nam. ~ I . m.ho"" Phon. """"'" I II II I <br />Fee SImp' TiU_' " AdO.." ,- .. - - · ; ;;;' ~ · · i - = ~ <br />-..., ---- (7:"~ _~;,'.& :~ a_ - -. - j <br />JobAd'''''' . YJ~_-) _ ~ 61'rl ( U~, 7-1~irt.,'I\{Er 31,Wo l Lo<' I - <br />==- _ [ _ . ~ _ "" I_~ P",::___ ~ l:~I:"N~~UMr.KUY;'~" :~NU":l ~I <br /> <br />.0 Blo-Hazal'd Waste Storage" ANNUAL D Fumigation Tent <br />o Comm Exhau$t Kitchen Hood/DUct 0 Hazardous Matenal (Tier II or RQ Faclllty) ANNUAL <br />o Controlled Bum .D' Hood Installation <br />D . Emergency Generatpr < 30 kw D LP/Natural Gas-Installation <br />o Emergency Generator:> 30 kw 0 l...p/Natura.1 Gas-ANNUAL Sale <br />o Fire Protection Maintenance" ANNUAl.. D places of A6Sembly"ANNUAL <br />Sprinkler D D Recreational Bum <br />Fire Alarm. .' 0 '0 SparJders <br />Mood Clean/Suppression W D Sprinkler System Inslallatlons <br />D Fire Alarm Installation 0 Standpipes (Sprinkler Sys) <br />D Fire Pumps D Torch Rooflng <br />. D Fire Works . D. Waste TIra Storage ANNUAL . <br />D Flammable Appllcatloll- ANNUAL <br />o Fuel Tanks 1.- ., Valuation of Project <br />D Other: <br /> <br />Contractor Company 8-i'~? .f,' I'"t 'fE:}t"C-c No:Jr-' <br />Signature ,Registered [Q2!,!!.J FeEl Current L Y I N I <br /> <br />-." cc,:1 p(:::!r' Li;""d 1";1'{''( z,??mJP09 7 I <br /> <br />ELECTRICIAN . Company [ <br />Signature _ Registered . L Y I N I Pee CUrrent Y I N I <br /> <br />Address [ I' Ucense 1# .' I I <br /> <br />PLUMaeR I ] COmp Y [ <br />. Signature. . . ReglS~~ed I . Y I N Fee Current Y I N I <br />Addre5S I _ J . License # . r I <br /> <br />MECHANICAl.:1 I company I. '. . . : <br />Signature RegIstered , Y I N I Fee Current [ Y IN' I <br />Address I J License # . ] I <br /> <br />~~::"' ~ I =::.l Y IN I Fe. CU...., I Y I N I <br />t5i~G~~ w__~_~~ ~~. -,If': - ..~...~._---~ -- - _..J. 7~~L.1:.~~~~ # .....C. . -~~-~-_'~4 ~_.- -.._l-..:... ~ <br /> <br />Fill out appllcatlon completely-' .. .. . .... <br />Owner & Contractor sign back of appllcatlon, 'notarized (Or, COPy of signed c:ontraGt with owner) <br />If over $2500. a Notice of Commencement Is required (Mechanical work over $5000) . <br />Supply two (2) sets of drawlngs with applicable documentallon <br />AllOw 10-14 days for review after submltta! date. <br /> <br />