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<br />/J.ft'-- <br />813-780-0020 '~.' -ef~~ity of -Zephyr hills Fire iJ; (Ji)O 3> Fax-813-780-0021 <br />~ ~ . f\C Permit Application [-1' V . <br /> <br />~~~~iii~~:~Q$li*~e;~t~"''-''~~i'~'''~~'''~''~'''"'_~'ilZ''~~;~~~~t~=~l212:,,",JL~2._jI~i <br />L~k=r:r() IvJ m b I Owner's Phone Number 1<6 J ~ 117 K~ II (0// (D <br />DP~D ~ ...ktT1%-K()Od <br />I . <br /> <br />Fee Simple Titleholder Address I <br /> <br />~"t;~JIl"lb/.!lIill~il'ji__~..j;fu~W'/lffl~l--'.l!I~~_ <br /> <br />Fee Simple Titleholder Name <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />I Titleholder Phone Number 1- <br /> <br />II <br /> <br />II <br /> <br />~n~ - <br /> <br />~~ .rn <br /> <br />...~~~~ <br /> <br />I Lot# I <br />I fJ\~ ~A~~U -r~!vl~~q~; 1r:!!~II:~?{)O () <br /> <br />~Q{)Je... <br /> <br />Parcel # <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br /> <br />D Fumigation Tent <br />D Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />D Places of Assembly-ANNUAL <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <br />D <br />D <br />D <br />D <br />D <br />9 <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />Sprinkler D <br />Fire Alarm ~ <br />Hood Clean/Suppression D <br />Fire Alarm Installation <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Valuation of Project <br /> <br />Other: <br /> <br />~~~~~'i"ii""'''-.~-''''''''''~'~~~ Ii~ -I <br /> <br />~ D('~ 'Q <br />Neo.VuL ~t <br /> <br />Contractor <br />Signature <br />Add",,, : ~ l:l1'1 <br />ELECTRICIAN <br />Signature <br />Address I <br /> <br />~-; -_~R;rm~~ ~~a 1'I'~~"*=~tm<~~ ~~ ~om.wtw~4 ~""m,~~ <br /> I Company []):.I'aJ~'i ~J~t'llI~~,""IrYL <br /> Registered <br /> N Fee Current <br />IYt1tClftJ i License # It: f: .. OOC\ICHt 0 I <br />Company I <br /> Registered Y/N Fee Current Y/N I <br /> I License # I I <br /> I Company I <br /> Registered Y/N Fee Current Y/N <br />~ License # I <br /> I Company I <br /> Registered Y/N Fee Current Y/N <br /> I License # I <br /> I Company I <br /> Registered Y/N Fee Current Y/N <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALj <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br /> <br />~=;~~I...+.."...,~..,.",,,.,""C"'_+"'.","".~"".-~'""'.~~''''''''''.''''"_W~''''''''''''''' "M'."!-_ ~;~~~L"'.""".".'"''"''~.Ci''''''' . "."'.,""''''''',.".....''''''''''_''''''''''''"'-~ <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. <br />