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<br />813-780-0020 <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 />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />-It 1115 <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br /> <br />L~JlJ I /2,2- <br />135 \.j2.. <br /> <br /> <br />Titleholder Phone Number I II <br /> <br />.39, UD <br /> <br />~~/\.r r Dr <br /> <br />2ef1hrk.'lls ) FL <br />I Parcel # <br /> <br />335Y2- <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 />~1~eomJIIAonll~ <br />Sprinkler bi.J if L-.J <br />Do ooc=J <br />Do ooc=J <br />Do ooc=J <br /> <br />11711Y <br /> <br />II <br /> <br />Job Address <br /> <br />I Lot# <br /> <br />Sub Division <br /> <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature . <br />Address I <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <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 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 /> <br />Sprinkler System Installations <br /> <br />Standpipes (Sprinkler Sys) <br /> <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <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 />D Fire Alarm Installation <br /> <br />B <br /> <br /> <br />El Fuel Tanks <br />D Other: I <br /> <br />Contractor ! /) ~4 <br />Signature ~ ~ <br /> <br />Address 35 ~l (, K~ + R.J <br />ELECTRICIANI <br />Signature . <br />Address I <br /> <br />Valuation of Project <br /> <br />Torfl>--\ )p"'J'l...~ ( <br /> <br />Fe :>~ ".! <br /> <br />OTHER <br />Signature <br />Address <br />Directions: <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />~ '1"\ So/vi-I"" <br />N Fee Current I 'to N <br /> <br />9 2- 3 S :s 2. 000 I ""2-00 '2.. <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 />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <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 />