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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 />""A'AI"'~':~':M~:Q...., ,..,....,@.1tLtXi <br /> <br />I ~II\.I W~'J5..E=" I Owner's Phone Number <br />15'I~ (,.Au... Bt..V D.t Z~"I2!-hLl~ t9.. <br /> <br />I <br />I <br /> <br />Date Received <br /> <br />}:' <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />. ,...1.,...1 1.......1 "H..""I <br />112~!!> ll.=tq~1J <br />I <br />I <br />I <br /> <br />II <br /> <br />1/ <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />15'l~5 ~^\...L 'e>UlD J2.EPHV2.tt1LL~ F=L ~L. I Lot# <br />I I Parcel # 1\0 '2.LP ZJ 0020'Obooooocool <br />(U!:!I AINcU I-HUM f"HUf"cH I Y I AX NU II(;c) <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 />[gJ <br /> <br />Sio-Hazard Waste Storage - ANNUAL <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Burn <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />Sprinkler ~ <br />Fire Alarm 0 <br />Hood Clean/Suppression 0 <br />Fire Alarm Installation <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 /> <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> <br />Hood Installation <br /> <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Burn <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />lo~l ~. 017 <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Valuation of Project <br /> <br />Other: <br /> <br />Contractor <br /> <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIANI <br /> <br />Signature <br /> <br />Address I <br /> <br />PLUMBER <br />Signature <br /> <br />Address I <br /> <br />MECHANICAL <br />Signature <br /> <br /> <br />Address <br /> <br />OTHER <br />Signature <br /> <br />Address <br /> <br />Directions: <br /> <br />Company <br />Registered <br /> <br />I Y/N <br />I <br /> <br />I Y/N <br />I <br /> <br />I Y/N <br />I <br /> <br />I Y/N <br />I I <br /> <br />~"N.E A:umMAlnL R~ ::t&I~Vl ~I <br />I Y I N I Fee Current I Y I N I <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br />License # <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Company <br />Registered <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <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. <br />