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<br />813-780-0020 <br /> <br />Date Received J <br />}~WiNwtr4'i-t%0::H*,WtM1Z-4fw.jHSWmii:!b~~'Mt'" <br /> <br />Owner's Name <br /> <br />City of Zephyrhills Fire <br />Permit Application <br />~"~"""",*""",,,,@~,,",~lm~__~I__'1_11WM___il<\i:(@;,*ii@_M~~::1~~;ct fD~~1':~i~l,tZI"4!~'~"4~lt.,2,i~",J:rl~1~'I'" <br />C, C'" ''\) ?\l.. -z..~ I Own~~s Phone Number I II II <br /> <br />fiw",",- tU t etec (( ~ ( "' . <br /> <br />Owner's Address "'1s" "l>> 'f <br /> <br />Fee Simple Titleholder Name I <br />Fee Simple Titleholder Address I <br /> <br />1fB{~1 <br /> <br />Fax-813-780-0021 <br /> <br />I Titleholder PhDne Number I <br /> <br />II <br /> <br />II <br /> <br />~i~,{ Huff fGfvt). <br /> <br />g".~.J.e /0 I <br />I <br /> <br />Job Address <br /> <br />I Lot# <br /> <br />Sub Division <br /> <br />Parcel # <br /> <br />D <br />M <br />D <br />D <br />D <br />D <br /> <br />D <br />8 <br />D <br />IE] <br />o'il!1!@@ll!llllill!!!ti(l~i!lliilll <br />Contractor <br />Signature <br />Address <br /> <br />Bio-Hazard Waste StDrage - ANNUAL <br />Comm Exhaust Kitchen HoodlDuct <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 />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 />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br />Fuel Tanks <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 />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 RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />'2, '''-0 .010 <br /> <br />Valuation of Project <br /> <br />-IlcbJ <5~~;~_Xilllilllillllii1Thl@i__l~$mm@iIlI1PJliIlIW4~!!iIlI!l~_1 <br /> <br />Other: <br /> <br /> <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 />Company I cB~l F\c. ""-+-r ~. <br />Registered Fee Current I N I <br />License # I 0' ) ""50 "1tio /(;("( I <br />Company I <br />Registered Y/N I Fee Current Y/N I <br />License # I I <br />CDmpany I <br />Registered Y/N Fee Current Y/N <br />License # I <br />Company I <br />Registered Y/N Fee Current Y/N <br />License # I <br />Company I <br />Registered Y/N I Fee Current Y/N <br />License # <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 />