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<br />"813-780-0020 <br /> <br />t: ro2Jff <br /> <br />Fax-813-780-0021 <br /> <br />City of Zephyr hills Fire. <br />Permit Application <br /> <br />~:=---1-~__fflj'" J <br /> <br />I <br /> <br />Fee Simple Titleholder Address I <br />_Wi r"': <br />Job Address I 38 \~S n'lAQ r::FT <br />I <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Sub Division <br />-[ <br /> <br />D <br />D <br />D <br />D <br />D <br />o <br /> <br />Contractor <br />Signature <br /> <br />Address <br />ELECTRICIANI <br />Signature . <br />Address I <br />PLUMBER I <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature <br /> <br />Address I <br /> <br />OTHER <br />Signature <br /> <br />_ ....~dressJ, <br />Directions: <br /> <br /> <br />5()"'-lf-~ (2 E <br />I <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br /> <br />Emergency Generator> 30 kw <br /> <br />Fire Protection Maintenance - ANNUAL <br />,~ l:seomq IAon11 ~ <br />Sprinkler ~ l!1' L-J <br /> <br />Fire Alarm 0 0 0 0 r==I <br /> <br />Hood Cleaning 0 0 0 0 r==I <br /> <br />Hood Suppression 0 0 0 0 r==I <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br /> <br />Pho~e Contact for Permit ] ~ \ ~ <br />. _lit'-llli -' "ii' - <br /> <br />Owner's Phone Number <br /> <br />Titleholder Phone Number <br /> <br />I <br />I <br />d~~~~~1 hlHtqi] "_~ <br /> <br />I Lot # I I <br />I <br /> <br />Parcel # <br /> <br />IIlJ!r!flIll _1Wll II~" <br /> <br />D Fumigation Tent <br />D Hazardous Material (Tier II or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />D Places of Assembly-ANNUAL <br /> <br />D Recreational Bum <br /> <br />D Sparklers <br /> <br />D Sprinkler System Installations <br /> <br />D Standpipes (Sprinkler Sys) <br /> <br />D Torch RoofinglTar Kettle <br />D Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />License # <br /> <br />I~~\ F~~~~nt rF0~flF(~~ <br /> <br />L~I1bLl 'r)'t.tCO\ (t /((({ <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 Fee Current Y/N <br />I Y/N I Fee Current Y/N <br />I <br />I Y/N I Fee Current Y/N <br />l "r r ' ',......t' C' , ~"...=",..,,,,...,"""l. _~1lI <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />"'1-...,,~-~,,-.J ~ 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://appralser.pascogov.com) <br /> <br />",- ",." <br /> <br />'i"'""'~'^ T .^~, '>>'M""^'~ <br /> <br />\"'i1 <br />