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<br />City of ZephyrhillsFire ...It '1Q tS 1 <br />Permit Application . f' . <br /> <br />'~~~;I'~:;:,i';:';!~;j)i!!:iI!!w"j)~I,~t~i~'k"<<'k'k""A'm'MJ%'%i!mmIW_\\Wi;lW;;Yf_t,iMfW""ll1l\m_%1i'_'_W[;JiiinfuJiiiW%:!%1~*':~~~~~~::~~"0iipl,","'~~""A"ijRLr~,~ <br /> <br />Owner's Name I /flt"a.N c... ~ (~ /Nt. c h I Owner's Phone Number I II <br /> <br />h2 ~ M <br /> <br />Owner's Address <br /> <br />813-780-0020 <br /> <br />Fax-813-780-0021 <br /> <br />LJ S'?'f'6 I <br />~".c.'>"<:'~"",,,:~,; ';0:;'0'- ":':"*' ,~OO;;'" ,,,,,;~,"',,;:":'''~'; '" <br /> <br />II I <br /> <br />Fee Simple Titleholder Name <br /> <br /> <br /> <br />II <br /> <br />II <br /> <br />I <br />I 1'925/ <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />r.;. <br /> <br />/c;~d <br /> <br />Parcel # <br /> <br />L., <br /> <br />I Lot# <br /> <br />Sub Division <br /> <br />Contractor <br />Signature <br /> <br />D 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> 30 kw <br />!21 Fire Protection Maintenance - ANNUAL <br />~~~~ <br />Sprinkler 0 0 0 0 L---' <br />Ei9 0 0 ,c=J <br />Do ooc=J <br />Doooc=J <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier \I or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofingrrar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Company <br />Registered <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />. Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />ISIC'c..I&t ll-Y &"'Ic~, c sy 5k....s z;".k:, <br />. Y I N I Fee Current _ Y I N I. <br /> <br />I I <br /> <br />I Y I N Fee Current Y I N I <br />I I <br /> <br />I Y I N <br />I <br /> <br />I Y I N <br />I <br /> <br />I Y/N <br /> <br />Address L 3/<1/'1 flC':a f- J..c- rI... <br /> <br />ELECTRICIANI <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />D Fire Alarm Installation <br /> <br /> <br /> <br /> <br />~ F~IT,"k, <br />D Other: I <br /> <br />I -/~ -- &/J <br /> <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />/1.+2.A- <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Fee Current <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 />Allow 10-14 days for review after submittal date. Parcel #.. obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />