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<br />813-780-0020 <br /> <br />Owner's Address <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Fee Simple Titleholder Name <br /> <br />. ] I <br />i'~:l~~"I~l~;;'~l~:I~1%gWll'_&m'i""h ihi"""",*",14i'"'''''''''' i1",,,"i_l!mg_w_t&"i.1?'4J'j""_Jii____..~~~~:,,~~~J"'i"'''''''''''iii <br /> <br />Owner's Name I 1) /?- 7-.1}. H V7 I Owne~s Phone Number <br /> <br />I b)"i8 Mu.. BlVD, <br /> <br />I <br />I <br />I ~~-'fg <br />I <br /> <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />Q,{}l(., B l. ~ ~ <br /> <br />Fax-813-780-0021 <br /> <br />""""""lJ""i11>li""iM,i'hiA""lliMi""'"hii"'Wh,i"", I <br /> <br />II II <br /> <br />I Titleholder Phone Number I <br /> <br />II <br /> <br />II <br /> <br />I Lot# <br /> <br />Parcel # <br /> <br />~ <br />D <br />I <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIANI <br /> <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br /> <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 />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~~~~ <br />Sprinkler 0 0 0 0 L-I <br /> <br />Fire Alarm 0 0 0 0 c=I <br /> <br />Hood Cleaning 0 0 0 0 c=I <br /> <br />Hood Suppression 0 0 0 0 c=I <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Other: <br /> <br /> <br />Directions: <br /> <br />o <br />o <br />~ <br />o <br />o <br />D <br />D <br />D <br />D <br />o <br />o <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 />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofingrrar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />I~~ <br /> <br />Valuation of Project <br /> <br />Company <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 />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 />ICJ7I2VS C'o~~"7'" SlitS..? <br />Y I N I Fee Current I <br /> <br />ese-oo r <br /> <br />"""k7j'- ',;G. <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 />