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<br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />I <br />City of Zephyrhills Fire <br />Permit IApplication <br />I <br />: Phone Contact for Permit <br /> <br /> <br />Fax-813c780-0021 <br /> <br /> <br />Owner's Phone Number <br /> <br />II <br /> <br />I J <br /> <br />:)\-. <br /> <br />II <br /> <br />II <br /> <br />I Titleholder Phone Number <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />"Sd ,--\~, <br /> <br />bi unSW\ vie <br /> <br />~I. <br />I ! <br />I <br /> <br />Parcel # <br /> <br />I Lot# <br /> <br />II ", , .., f". I. '. - . --, ... . . , I <br />L: ..,...(~, .~( _L~.H"<'C. ...1......,' ~"')(,__,,--..<_L''-l~, <br />CUts I AINl:;U I-KUM t-'KUt-'l:;K I Y I AX NU 11L.;l:;) <br /> <br />o <br />o <br />o <br />o <br />o <br />o <br /> <br />o <br />o <br />o <br />D <br />D <br />o <br /> <br />,--- <br />Contractor <br />Signature <br />Address <br /> <br />ELECTRICIAN <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature . <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />Address <br /> <br />D Fumigation Tent <br />D Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />~/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />I D Places of Assembly-ANNUAL <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br /> <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 />Sprinkler D <br />Fire Alarm D <br />Hood Clean/Suppression D <br />Fire Alarm Installation <br />Fire Pumps <br /> <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Valuation of Project <br /> <br /> <br />,r F'( C7... <br />/.-jL-, '-~ <br /> <br />Other: <br /> <br /> Company <br /> Registered <br /> License # <br /> Company <br /> Registered <br />I I License # <br />I I Company <br /> Registered <br />'t I <br /> License # <br /> I Company <br /> Registered <br /> I License # <br /> I Company <br /> Registered <br /> License # <br /> <br />(~I~S p(~ <br />I N Fee Current N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y / N I Fee Current <br /> <br />Y/N <br /> <br />Y/N I .FeeC~rrent <br /> <br />Y:/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Directions: <br /> <br />I <br />Fill out application completely. I <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 (Mechani~1 work over $5000) <br />Supply two (2) sets of drawings with applicable documentation I <br />Allow 10-14 days for review after submittal date. <br />I <br />