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<br />813-780-0020 <br />. <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />City of Zephyrhills Fire- <br />Permit Application <br /> <br /> <br />11 1011 <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Owner's Phone Number Lsw I ? I C; II () I) {, 0 I <br />325'10 <br /> <br />Titleholder Phone Number I <br /> <br />II <br /> <br />/I <br /> <br />Job Address <br /> <br />s _~ 5 lot 0 1 Lot # <br /> <br />Sub Division <br /> <br />3<i.9Db <br /> <br />M}f A V~ <br /> <br />Le f>l.r~ ,'/J ( <br />I Parcel # <br /> <br />\-= L. <br />I <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~,ry ~ ~~er <br />D 0 0 0 <br />00 0 <br />Doooc] <br />Do 0 DC] <br /> <br /> <br />Contractor <br />Signature <br />Address <br /> <br />Signature <br />Address I <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature , <br />Address I <br /> <br />OTHER <br /> <br />Signature <br /> <br />Address <br /> <br />Sprinkler <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />D <br />B <br />D <br />D <br />D <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />D <br />D <br />D <br />B <br />D <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II 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 RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Company <br /> <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 />Company <br />Registered <br /> <br />License # <br /> <br />~I So 1,,+,'01 <br />rc;ryNl Fee Current I (~ I N <br />- <br />[]:; F DOCX) \.{ Y t <br /> <br />I Y IN <br />I <br /> <br />I Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <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 />