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<br />813-780-0020 <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Date Received <br /> <br />r-- <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />I Shree Sai LLC <br />16815 Gall Blvd. Zephyrhills, FL 33541 <br />II <br />Pankaj Patel <br />29341 Rhodin Place Wesle Cha el, FL 33545 <br /> <br />Fee Simple Titleholder Name <br /> <br />Job Address <br /> <br /> <br />H <br /> <br />Lot # <br /> <br />Phone Contact for Permit <br /> <br />Fax-813-780-0021 10 <br />~P:; ~ <br />?~?:tT~fl/.F1~561 <br />81311 76211 20001 <br />I <br />81311 97311 24211 <br /> <br />Owner's Phone Number <br /> <br />I Titleholder Phone Number <br /> <br />Sub Division <br /> <br /> <br />o <br />o <br />o <br />o <br />o <br />~ <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 /> <br />Sprinkler G::J <br /> <br /> <br />Fire Alarm 0 0 <br /> <br /> <br />Hood Cleaning 0 0 <br /> <br /> <br />Hood Suppression 0 0 <br /> <br />IS~mq IA~'llother <br /> <br /> <br />o 0 I <br />o 0 I <br />o 0 I <br /> <br />o Fire Alarm Installation <br />o Fire Pumps <br />I I Fire Works <br />Flammable Application- ANNUAL <br />o FuelTanks <br />o Other: I <br /> <br />I~~ <br /> <br />Parcel # <br /> <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <br />o <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 /> <br />Recreational Burn <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofinglTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Valuation of Project <br /> <br />!.fj;L^ j{;;;;<jY~; >y;/;, <br /> <br /><;>f);,;lU <br /> <br />" -C"Vjb10l:jTcXij <br /> <br />YTtj<; <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 />Address I <br />Directions: <br /> <br />"",. 001;;"'" ....yy:~<3ili0;;;;jWGW?ii21iJijYJI2Jli!*i0%!2:fj;;'YJrcij;; :J!S}:Z;[f/;ltMffiY$ <br /> <br /> <br />rii;;U51jA'~f'" <br /> <br />Company <br />Registered <br />License # <br />Company <br />Registered Y/N I Fee Current Y/N <br />License # <br />Company <br />Registered Y/N I Fee Current Y/N <br />License # <br />Company <br />Registered Y/N I Fee Current Y/N <br />License # <br />Company <br />Registered Y/N I Fee Current Y/N I <br />License # L ... <br /> '''':';;T':;; <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 (hltp://appraiser.pascogov.com) <br />