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<br />Date Received <br /> <br />813-780-0020 <br /> <br />1tca~Ol <br /> <br />City of Zephyr hills Fire <br />Permit Application <br /> <br />Fax-813-780-0021 <br /> <br />Phone Contact for Permit <br /> <br /> <br />Owner's Phone Number <br /> <br />~/3 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />I ~ N C. !....>4-.Sf .r5 <br />I & ~/ {.. <br /> <br />E4,,>rf f4~~ <br /> <br />t~l/ BlvD. <br /> <br />11"7 Y.2 I JSSI/ I <br />I <br />II II I <br />I <br /> <br />2-~~7rJ..,'//", FL <br />I Titleholder Phone Number <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />5<3TY ~ <br /> <br />Job Address <br /> <br />Sub Division <br /> <br />I Lot# <br /> <br />(Uti I AINt:U I-KUM I-'KUI-'t:K I Y I AX NU 11L;t:) <br /> <br />Parcel # <br /> <br />WM!lI\Wl!lfllt@l@glllWii_ <br /> <br />Contractor <br />Signature <br />Address <br />ELECTRICIANI <br />Signature . <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 />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 />Bio-Hazard Waste Storage - ANNUAL <br /> <br />D <br />D <br />D <br />D <br />D <br />~ <br />D <br />D <br />D <br />D <br />D <br /> <br />Comm Exhaust Kitchen Hood/Duct <br /> <br />Controlled Bum <br /> <br />Emergency Generator < 30 kw <br />Emergency Generator> 30 kw <br />Fire Protection Maintenance - ANNUAL <br />Sprinkler D <br />Fire Alarm D <br />Hood Clean/Suppression D <br />Fire Alarm Installation <br /> <br />Fire Pumps <br /> <br />Fire Works <br /> <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />Fumigation Tent <br />Hazardous Material (Tier II or RQ Facility) ANNUAL <br />Hood Installation <br />LP/Natural Gas-Installation <br />LP/Natural Gas-ANNUAL Sale <br />Places of Assembly-ANNUAL <br />Recreational Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch Roofing <br />Waste Tire Storage ANNUAL <br /> <br />Other: <br /> <br />Valuation of Project <br /> <br /> <br />Company <br />Registered <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Company <br />Registered <br /> <br />Y I N Fee Current <br /> <br />Y/N <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Company <br /> <br />Registered <br /> <br />License # <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />Directions: <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 />