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<br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />City of Zephyr hills Fire- <br />Permit Application <br /> <br />VUeA') <br />S-b~~ <br />I <br />I <br />5~S-~ <br /> <br />~ <br /> <br />Gf\\\ <br /> <br />~\\1d <br /> <br />.if' 61-(1 <br /> <br />Fax-813-780-0021 <br /> <br />II U I <br />"'"''''''~''':>1<N"""..~ffism~"":;':;-''N~~'''''""':'''''''''''''''':Qi;.i"",'',,,_;;;;,,,,~,;';;"'.';'..,~",,,,,,, <br /> <br />II I-I I <br /> <br />Owner's Phone Number <br /> <br />Fee Simple Titleholder Address <br /> <br />I Titleholder Phone Number <br /> <br />II II <br /> <br />Job Address <br /> <br />~f\ \ \ <br /> <br />I Lot#1 <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 />ELECTRICIANI <br /> <br />Signature . <br /> <br />Address I <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br /> <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br />Signature <br />Address <br />Directions: <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 0 0 0 0 L-J <br />Fire Alarm 0 0 0 0 c=J <br />Hood Cleaning 0 0 0 0 c=J <br />Hood Suppression 0 0 0 0 c=J <br /> <br />D Fire Alarm Installation <br /> <br />D <br />D <br /> <br /> <br />B Fuel Tanks <br /> <br />D <br />~' <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />o Fumigation Tent <br />o Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />: ~Natural Gas-ANNUAL Sale <br />Pi aces of Assembly-ANNUAL <br /> <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (SprinklerSys) <br />D Torch Roofingrrar Kettie <br />D Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />Other: <br /> <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # I <br />Company I <br />Registered <br />License # <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <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 />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fill out appiication compieteiy. <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 />