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<br />813-780-0020 <br /> <br />Date Received <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />i#:35131 <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Phone Contact for Permit <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />\ Ll.p~ola <br />'A--t-Tn.IQ~L I Cet'\~ <br />I <br />I <br />9 oCf G a \ \ <br /> <br />I ~5 113,Q 115/001 <br />marl.. u IH~-:rJ..-J 37<?D <br /> <br />I Titleholder Phone Number I II II <br /> <br />L../--r) C. <br />1 '50 Li). Ch '-4fCJ, fhI.e <br /> <br />Owner's Phone Number <br /> <br />I <br />I <br />rh,rl~ FL 335~ Lot# I I <br />3Lf- 2S-2 (-00 I o-OOtoo-oa::n <br /> <br />Fee Simple Titleholder Name <br /> <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 />D <br />D <br />D <br />D <br />D <br />D <br /> <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 />~ Places of Assembly-ANNUAL <br /> <br />D Recreational Burn <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch Roofing/Tar Kettle <br />D Waste Tire Storage ANNUAL <br /> <br />Bio-Hazard Waste Storage - ANNUAL <br />Comm Exhaust Kitchen Hood/Duct <br />Controlled Burn <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />~ <br />Sprinkler D 0 <br />Fire Alarm D 0 <br />Hood Cleaning D 0 <br />Hood Suppression D 0 <br />Fire Alarm Installation <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br />Fuel Tanks <br />Other: <br /> <br />~~~ <br />o DL-J <br />o 0 CJ <br />o 0 CJ <br />o 0 CJ <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Valuation of Project <br /> <br />Contractor <br />Signature <br />Address I <br />ELECTRICIAN <br />Signature I <br />Address I <br />PLUMBER <br />Signature <br />Address I <br />MECHANICALI <br />Signature . <br />Address I <br />OTHER <br />Signature <br />Address <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />Directions: <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Fee Current <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 />