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<br />City of Zephyrhills Fire <br />Permit Application <br /> <br />~~~~il~:i1:~~:~~!W~mm$@L'$"41:4et"~I;'!:~'''''Ml--_---k,r~~-_~~~tact ~or ~:~~I-L"~"m"4~I~Lt",w%~".$~JwI.IAM"~~MI.'I,,",,1 <br />::::::" ~fr[./: ~:~ ~;~:-I'.r'(~a.l8a.v-I~(;PhooeN",""" 1.,/3 ~ 17<1'3-- ~ It'i'<t I ! <br /> <br />I I Titleholder Phone Number I II II I <br />I I <br />I. 570'7 ~).J- Cn.iL Blud. ~ ~~'(15 PL.- 1,01# I <br />. I ~~~e~# I I <br />o <br />o <br /> <br />D Hood Installation <br /> <br />D <br />D <br /> <br />l2l Places of Assembly-ANNUAL <br /> <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />o Torch RoofingfTar Kettle <br />D Waste Tire Storage ANNUAL <br /> <br />813-780-0020 <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />o <br />o <br />o <br />o <br />o <br />o <br /> <br />Contractor <br />Signature <br /> <br />Address <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 />Bio-Hazard Waste Storage - ANNUAL <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br /> <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~~~~ <br />Sprinkler D 0 0 0 L-J <br />D 0 0 0 CJ <br />D 0 0 0 CJ <br />DDDDCJ <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />~ <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br />Other: <br /> <br />1f'B (O'l <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br /> <br />Valuation of Project <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />--j <br />I <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Fee Current <br /> <br />Y/N <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 />