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<br />City of .Zephyrhills Fire <br />Pennit Application <br /> <br />,~~!~?~~i~~~"..;".mr,,!J"""'<"'W","....__._".~J~~_~_"'_}f;l'%~,;:~!~~~~~~'ci7L... <br />--::r=t:f7C6"' I ~s Phone Number I <br /> <br />I <br /> <br />Fee Simple TItleholder Address ., <br /> <br />'~I~~~_~K=T-- <br /> <br />Sub Division _ <br />s.:T~;;:;~:'::JFiE,:;:::,.,'_.~-;.<.,~,,_:-s~"='>kW;;;i-g~L1W',~~:'~~~~~~~!2~:;-~~~",~};;~,:t,~;:;:~~~#~~'..;~~.;.mii.:t17'.;1"~0.1q~~,'.itl:-~'i:::',~,~.~.':,-~:"::'ZT;m:z:tI~;~;;,;~t::r <br /> <br />813-taO-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />OTHER <br />Signature <br /> <br />I- )' IW"JB:)IL -.I <br /> <br />Fax-813-780-0021 <br /> <br />L-' <br />~ I <br />II <br /> <br />I Titleholder Phone Number I <br /> <br />.,~.LL <br />II <br /> <br />II <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 />I <br /> <br />Fumigation Tent <br />Hazardous Material (TIer II or RQ Facility) ANNUAL <br />Hood Installation <br />LPlNatlnl Gas-Installation <br />LPINaturaI Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br /> <br />Recreational Bum <br /> <br />Sparklers <br /> <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofingITar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />~ ~~~=-- <br /> <br />D Other: I <br />2;~_1::Y;1Z::::::z'_.J;nl:&'~~~~~~;~~uZk~ fiazr:ii"-~ll!1t.ua,\lll::d!kk!1.. -~""'lQ~~~~~~':~~~~-';:'~~M~'9.lWl~~~s;.1!Z!"d8S.~E(:):1":Z'.s:",2::S; <br />Contractor I Company <br />Signature . Registered Y / N I Fee Current I Y / N I <br />Address I Ucense # I <br />ELECTRICIAN! Company <br />Signature I Registered Y / N I Fee Current Y / N I <br />Address I Ucense # I <br /> <br />PLUMBER I Company <br />Signature Registered Y / N I Fee Current Y / N I <br />Address I Ucense # I <br /> <br />MECHANICALI Company <br />Signature . Registered Y / N I Fee Current I Y / N I <br />Address I Ucense # I <br /> <br />Bic-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 />'D~~~~ <br />o OOL-J <br />Doooc=J <br />ca--- 0 ~ 0 c=J <br />W--o V 0 c=J <br /> <br />Sprinkler <br /> <br />Fire Alarm <br /> <br />Hood Cleaning <br /> <br />Hood Suppression <br /> <br />Fire Pumps <br />FireWorks <br />Flammable Application- ANNUAL <br /> <br /> <br />Company <br />Registered <br /> <br /> <br />Address /, 3S 6 <br />~~~~'--~""."l~<-'M>'~-""'''''' ~_. "'_c""'_~, .....,.","""., <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 Commel IC8I1ll!nt is required (Mechanical work over $5000) <br />Supply two (2) sets of drawings with applicable documentation <br />Allow 10-14 days for review aftersubmltlal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br /> <br />License # <br />