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<br />813-780-0020 <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Date Received <br /> <br />-11-c;) "Y <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />~ l? 331 <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Phone Contact for Permit <br /> <br />Parcel # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />Company <br />Registered <br /> <br />License # <br /> <br />I f'v"", Go-- 4. r~ ~ - 'I" f) "" 11 te- I Owner's Phone Number <br /> <br />157/~ Cr~1/ 81 vtl ~"-f,i.-/(& FI <br /> <br />I I Titleholder Phone Number <br />I <br /> <br />II 'l'r~ I J <br /> <br />II II <br /> <br />Job Address <br /> <br />S-f (~ <br /> <br />Cr4U <br /> <br />{3(,rl <br /> <br />2fh.lff <br />I <br /> <br />Sub Division <br /> <br />D Fumigation Tent <br />D Hazardous Material (Tier 1\ or RQ Facility) ANNUAL <br />D Hood Installation <br />D LP/Natural Gas-Installation <br />D LP/Natural Gas-ANNUAL Sale <br />D Places of Assembly-ANNUAL <br />D Recreational Bum <br />D Sparklers <br />D Sprinkler System Installations <br />D Standpipes (Sprinkler Sys) <br />D Torch Roofing <br />D Waste Tire Storage ANNUAL <br /> <br /> <br />J ..7' 0 - Valuation of Project <br /> <br />D Bio-Hazard Waste Storage - ANNUAL <br />D Comm Exhaust Kitchen Hood/Duct <br />D Controlled Bum <br />D Emergency Generator < 30 kw <br />D Emergency Generator> 30 kw <br />~ Fire Protection Maintenance - ANNUAL <br /> <br />Sprinkler <br />Fire Alarm <br /> <br />D <br />D <br />[RJ <br /> <br />D <br />D <br />D <br />D <br />D <br />D <br /> <br />Hood Clean/SuppressiQD.. <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <br />"3 ~>V( I Lot# <br />I <br /> <br />(U!; I AINt:U I-KUM t-'KUt-'t:K I Y I AX NU 11L;t:) <br /> <br />Other: <br /> <br />I <br /> <br />J<.{~1T <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Address I <br /> <br />MECHANICALI <br />Signature . <br /> <br />Address 1 <br /> <br />OTHER <br />Signature <br /> <br />I <br /> <br />Address <br />Directions: <br /> <br />I ~,--,c..,&;-; 4~ /14 c::..- <br />Y I N I . Fee Current I Y I N <br /> <br />173 V~'fSo~al(~"f <br /> <br /> <br />I Y I N I Fee Current <br /> <br />I <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <br /> <br />. Y I N I Fee Current <br /> <br />Y/N <br /> <br />Y I N I Fee Current <br /> <br />Y/N <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 />