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<br />,813-780-0020 <br /> <br />City of Zephyrhills Fire- <br />Permit Application <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Phone Contact for Permit <br /> <br />Owner's Name <br /> <br />Igt ~ <br /> <br />II ;5"0 II q;ro <br /> <br />Date Received <br /> <br />Owner's Address <br /> <br />N OV,4 C.u:.fHJ J MG ~e({))Jc...e: Ie. Owner's Phone Number <br />p. O. &0 X TAmPA 1=1, 33677 <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br /> <br />Titleholder Phone Number I <br /> <br />II <br /> <br />II <br /> <br />Job Address <br /> <br />1 Lot# <br /> <br />me DONALD 'S GOLl<). GALL g[jtJ) .;lePltytp.IlJ.,S, 33540 <br />/ I Parcel # I <br /> <br />Sub Division <br /> <br />Contractor <br />Si9nature <br /> <br />Md~1 <br />ELECTRICIAN <br />Signature <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 /> <br />Address <br /> <br />Directions: <br /> <br />D <br />D <br />D <br />D <br />D <br />D <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 />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 />~~ooc=J <br />Doooc=J <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />D <br />B <br />B <br />D <br />I <br /> <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks C <br />Other: I UOOf) UfiNI/JG ill/a <br /> <br />DEL A { e:.t..e..N c..;z..t . <br />p.o. BOX, 4Qvv rAfYlPA. fl. 33G 77 <br />, <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 />0:2 <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <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 />Valuation of Project <br /> <br />~ I <br />BE bolJe ON AU6tfSTj /J. ! OJ <br /> <br />Y/N I Fee Current Y/N <br />Y/N I Fee Current Y/N <br />Y/N I Fee Current Y/N <br />Y/N I Fee Current Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <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 />