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<br />City of ZephyrhillsFire <br />Permit Application <br /> <br />"~~~~i!~~~~~'~~~!IIWii'W'ili!QsL!,~>!"!!!!"!:,,!;,,,.!!_~,,"",,,,lm!If_MiWM%_(_a___!Mi'H_~dl1lMW!!il\'_i@:~~~~~~~:;,~>J,!l,~!,,,,..LL'~"~'ij;m;L~i~,,~J <br /> <br />I ~~~~-d:~o:~;;;;- ~',Phoo.N"_' I ~/s ~ 1/~8 ~I J22<~ <br /> <br /> <br />I I Titleholder Phone Number I II II I <br /> <br />I I <br />I <br />I <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br /> <br />-tY fAct 7 <br /> <br />Fax-813-780-0021 <br /> <br />Lot# <br /> <br />I <br /> <br />Sub Division <br /> <br />Parcel # <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Contractor <br />Signature <br /> <br />Address <br /> <br />ELECTRICIAN <br /> <br />Signature <br />Address I <br />PLUMBER I <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature <br /> <br />Address I <br /> <br />OTHER <br /> <br />Signature <br /> <br />Address <br /> <br />Valuation of Project , -tv <br />~rb~-::fu-r <br /> <br /> <br />License # I "'<<Oc:::.~{} JJqq-, I <br /> <br />Company I <br />Registered Y I N Fee Current Y I N I <br /> <br />I <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 />~~~~ <br />Sprinkler D 0 0 0 L--J <br />Do ooc=J <br />Doooc:=J <br />Do o.;Vc=J <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />D <br />D <br />B <br />D <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br />Fiammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />o <br />o <br />o <br />o <br />D <br />D <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ. Facility) AN~,lJAL. ."c). ..', ." <br /> <br />Hood ,Installation () 8 <br /> <br />LP/Natural Gas-Installation / ..' ~' 1 - il1A..- <br />LP/Natural Gas-ANNUAL SalE( L\"li)'./:3 f}/ <br /> <br />Places of Assembly-ANNUAL "--~ A-{IQ..~ <br /> <br />Recreational Bum J)> /.- (" fI'\ , <br />~deao <br />.I.A {,tLtk-t ~-'-4 <br />5J~ cp/2Jf'\ -J--t!- ~123 <br />J~~~ <br />C tliLJ/~ ~ <br /> <br />Sparklers <br /> <br />Sprinkler System Installations <br /> <br />Standpipes (Sprinkler Sys) <br /> <br />Torch Roofingrrar Kettle <br />Waste Tire Storage ANNUAL <br /> <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 />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 />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 Property Tax Notice (http://appraiser.pascogov.com) <br />