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<br />City ofZephyrhills Fire. <br />Permit Application <br /> <br />=~\"~/J~+.. <br /> <br />~ <br /> <br />Owner's Address <br /> <br />I I TItleh0Ider Phone Number I <br />I <br />I 5"'<<.:;20 G:i41-L " ) <;LLJ;:::; I Lot # I <br />i I <br /> <br />;3"~~"':";~;~77:~~~;i1>:;:iYJ~i;~11fW~~.-~~~*"'~~~'~"*.tZ:?;~~~~..:~.;i.?i",:;~;:";::e.~~-",~".",M;;';'.l.~,01':.~";!"~~,lJ:.~~'::~~::',~';~~:'::'~7R:i.-:t~~~~dZ:':;:. <br /> <br />813-780-0020 <br /> <br />Fee Simple Titleholder Name <br />Fee Simple Titleholder Address <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Bia-Hazard Waste Storage - ANNUAL <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 />. [9!'!1~~~ <br />OoooL-J <br />OoooCJ <br />DoooCJ <br />~o ~o CJ <br /> <br />Sprinkler <br /> <br />Fire A1ann <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />~ ~~::- <br /> <br />D Other: I <br />r';:i':!;;t7.{L1;;;:~~;;1i~~'iif <br />I <br /> <br />Parcel # <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br />o <br />o <br />o <br />o <br />D <br />D <br />~ <br /> <br />Fax-813-78lJ..0021 <br /> <br />..u U. <br />,~""""~,.",....,,,-,,,,"~,, ,*,,,..,.~ ", <br /> <br />:~P711 <br />II II <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/NatUra1 Gas-Installation <br />LP/NatUra1 Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofIngrrar Kettle <br />Waste TIre Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />~~..~~~'-Ym.""~~'l:~~'l!T'tl~_:~~~....i.S'"o/:~",1~~~:~B.i~E'-ft:,~;~t"tl?.L: <br /> <br />Contractor <br />Signature <br /> <br />Address I <br /> <br />ELECTRICIANI <br />Signature <br /> <br />Address I <br /> <br />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 /> <br />Company <br />RegIstered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />RegIstered <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y/N I Fee CUrrent I Y/N I <br /> I <br />Y/N I Fee Cunent I Y/N I <br /> I <br />Y/N I Fee Cunent I Y/N I <br /> I <br />Y/N I Fee Current I Y/N I <br /> I <br /> <br />..5~,<..r"'y r;::?e {;;.Or.."O'Hri'I./-r- <br />CY.:'bN I Fee Cunent I Y / N I <br /> <br /> <br />Address /- 336. ...... <br />t!:..~~*"-"Il'li'''''---'' "', M -~-~"""~",=,,,,".' """"-"''"''''''''-''''''H''fiiit:...~,..,^,~.~ -- <br />Directions: <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 CommellCEllTl8nt is required (Mechanical wort< over SSOOO) <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 /> <br />.,.,.~',., <br />