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<br />OCT/31/~007 /WED 02: 18 PM ZEPHYRHILLS BUILD INC <br /> <br />813-780,0020 <br /> <br />Date Received <br />ar- , ~w <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />FAX No. 813-780-0021 <br /> <br />P. 002 <br /> <br />City of.Zephyrhills Fire <br />Permit Application <br /> <br />Fax-S1~H8D.0021 <br /> <br /> <br />Phone Contact for Permit ]~ L~~,JJ..(l.JJJ <br />IA ( 3 11'78"0 l./t'Yt:Dl <br />.3351-1 <br /> <br /> <br />Titleholder Phone Nurnber I <br /> <br />Fee Simple Titleholder Name <br /> <br />I <br />] J <br />f! IilI .. 1 I1IIIlI'~ r -.ll ~L,.fl~ -""-. ~ <br /> <br />lL21.J ~ .- ~+h ~1YeeA - ?eP\yr-hi' I::> Il.ot#. I I <br />lPotice- ~(Yi/iYT]('lJ+ I Parcel # .,b~:~~~~Jv~~~R0~~Sf?~~?~ J <br />. ~T ...dI I . r I 1'''' ~l <br />Blo-Hazard Waste Storage ~ ANNUAL D Fumigation Tent <br />Cornm Exhaust Kitchen HoodJDuct 0 Hazardous Material (Tier" or RQ Faclllty) ANNUAL <br />Controlled Bum .D. Hood Installation <br />. Emergency Generatpr < 30 kw D LP/Natural Gas-Installation <br />Emergency Generator> 30 kw D LP/Natural Ga5-ANNUAL Sale <br />Fire Protection Maintenance - ANNUAL D places of A6s6mbly-ANNUAL. <br />~ D Recreatlonal Bum <br />D .0 Spar1ders <br />Hood Clean/Suppression 0 D Sprlnl<ler System Installatlons <br />D Standpipes (Sprinkler SY5) <br />o <br />D <br /> <br />W .flrL). ()()t Valuation of Project <br /> <br />II <br /> <br />II <br /> <br />- <br /> <br />_.<1 <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />sub Division <br /> <br />~ 2TItiLlil~~- <br /> <br />.D <br />o <br />o <br />D <br />i <br /> <br />o <br />D <br />.D <br />D <br />D <br />o <br /> <br />~ <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIAN l <br />Signature I <br /> <br />Address I <br /> <br />PLUMS!::R I <br />Signature <br /> <br />SprInkler <br /> <br />Fire Alarm <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAl.. <br /> <br />Fuel Tanks <br /> <br />~_._- <br /> <br />....-0..___., <br /> <br /> <br />Torch Roofing <br />Waste Tire Storage ANNUAL . <br /> <br />11 <br /> <br />11IIIII <br /> <br />-<1~ <br /> <br />_.t~ I:CIll'IJ2. <br /> <br />Other: <br /> <br />v- <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />~~~~~re ~ I <br />.~- AE~~~~;;~t~~f({~~lJJllll~UL:._~J.- <br />DlTections: . <br />Fill out applh::atJon completl:'ly. . <br />Owner & Contr~ctor. sign back of application, 'notarized (Or, copy of signed contract with owner) <br />If OVBr $2500, II Notice of Commencement Is required (Mechanical work over $5000) <br />Supply t\No (2) sets of drawings wIth applicable documllntatlon <br />Allow 10-14 days for review after submIttal dati;!. <br /> <br />Address I <br /> <br />M. ECHA.NICAl.:j <br />Signature <br /> <br />Address I <br /> <br />--~~: <br /> <br />Company I <br />' Registered Y I N <br /> <br />l.lcense #1' . <br /> <br />Company [ <br />Registered L Y IN' <br /> <br />Licen5e # . I <br /> <br />Company I <br />RegIstered . Y I N <br /> <br />License # ., <br /> <br />Company I <br />Reglstllred , Y IN!. <br /> <br />License # I <br /> <br />Company j <br />Registered (;;fJJ N J <br /> <br />~l~~~e # ~i;:~..__~_~ <br /> <br />FeEl Current Y I N <br /> <br />Pee Current I Y I N <br /> <br />Fee Current Y I N <br /> <br />Fee Currant r- Y I N I <br />I <br /> <br />Fee Current I @ N ! <br />"'_,,~: ~ m.~_"_~:"L~,,,, ~ <br />