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<br />City orZephyrhills Fire
<br />Permit Application
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<br />J L71 S2Lo +fOP..V/1T/f I Owner's Phone Number Ig /.~ IIS4S-11'135/
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<br />813-780-002Ci
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Name
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<br />Fee Simple Titleholder Address
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<br />Job Address
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<br />Sub Division
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<br />Fax-813-78D-0021
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<br />I Titleholder Phone Number
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<br />Bic-Hazard Waste Storage - ANNUAL
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<br />Contractor
<br />Signature
<br />Address I
<br />ELECTRICIAN
<br />Signature I
<br />Address I
<br />PLUMBER
<br />Signature
<br />Address I
<br />MECHANICALI
<br />Signature .
<br />Address I
<br />OTHER
<br />Signature
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<br />Directions:
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<br />I I Valuation of Project
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<br />I HOOD ~)(~:'T C~}'/IJJG.- ~z)Il~ ~~'::t
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<br />Company ILlI.//I/a.-R~i3 SEft///Ct7S
<br />Registered Y / N , Fee Current I Y I N I
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<br />License # I I
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<br />Company I
<br />Registered Y / N I Fee Current Y I N I
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<br />License # I I
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<br />Company I
<br />Registered Y / N
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<br />License # I
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<br />Company I
<br />Registered Y I N I Fee Current
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<br />License # I
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<br />Company I
<br />Registered Y / N ,. Fee Current
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<br />Comm Exhaust Kitchen Hood/Duct
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<br />Controlled Bum
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<br />Emergency Generator < 30 kw
<br />Emergency Generator> 30 kw
<br />Fire Protection Maintenance - ANNUAL
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<br />Sprinkler
<br />Fire Alarm
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<br />Hood Clean/Suppression
<br />Fire Alarm Installation
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<br />Fire Pumps
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<br />Fire Works
<br />Flammable Application- ANNUAL
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<br />Fuel Tanks
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<br />Other:
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<br />G/fLL 15L1/D.
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<br />I Lot#
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<br />Parcel #
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<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
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<br />Places of Assembly-ANNUAL /
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<br />/ 1 g /~~
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<br />Recreational Bum
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<br />Sparklers
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<br />Sprinkler System Installations
<br />Standpipes (Sprinkler Sys)
<br />Torch Roofing
<br />Waste Tire Storage ANNUAL
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<br />filmS
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<br />Fee Current
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<br />Y/N
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<br />Y/N
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<br />Y/N
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<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 1D-14 days for review after submittal date.
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