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<br />813-780-0020 <br /> <br />City of Zephyrhills -Fire <br />Permit Application <br /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />i V; <br /> <br />1 \ v..~ e <br /> <br />I.AlN <br /> <br />Owner's Address <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Phone Contact for Permit <br /> <br />II <br />II <br /> <br />II <br />; I <br /> <br />Owner's Phone Number <br /> <br />Parcel # <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />I Titleholder Phone Number 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 />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~~~~ <br />Sprinkler D 0 0 0 L-I <br />Fire Alarm D 0 0 0 c=J <br />Hood Cleaning 12LI. 0 0 c=J <br />Hood Suppression D 0 0 0 c=J <br /> <br />D Fire Alarm Installation <br /> <br />D Fire Pumps <br /> <br />D Fire Works <br />D Flammable Application- ANNUAL <br /> <br />D Fuel Tanks <br /> <br />D Other: <br /> <br /> <br />contractor! "\) <br />Signature 1..u. ~ <br /> <br />Address . 6 <br /> <br />Job Address <br /> <br />5.J. \ \.( <br /> <br />GC\.~\ ~\V'~ <br /> <br />I Lot# <br /> <br />I <br /> <br />Sub Division <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 /> <br />AJ;jL <br />~- <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 />(.4:.V'oI\f"co-\ SeAl' \lite:::; <br />Y I N Fee Current I Y I N <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 />\f~r6" <br /> <br />ELECTRICIANj <br />Signature . <br />Address I <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature . <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address <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 />Company <br />Registered <br /> <br />License # <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 />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <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 Properly Tax Notice (http://appraiser.pascogov.com) <br />