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<br />Date Received <br /> <br />813-780-0020 <br /> <br />-JY<& ? fJ/ <br /> <br />City of Zephyrhills Fire <br />Permit Application <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Phone Contact for Permit <br /> <br />II <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />C l-v.13 H()v,)c I Owner's Phone Number <br />;Z~Y',wte .!/IUS PI- 33S-4/ <br /> <br />I &..~ li~r).bJA <br />17bJf~ G-e~ SW/ I'c J>K:. <br />I <br />I <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />II <br /> <br />I Titleholder Phone Number <br /> <br />II <br /> <br />II <br /> <br />Job Address <br /> <br />I Lot# <br /> <br />Sub Division <br /> <br />Parcel # <br /> <br />@!f~ <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 />Bio-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 />~~~~ <br />Sprinkier D 0 0 0 L-J <br /> <br />Fire Alarm D 0 0 0 c=J <br /> <br />Hood Cleaning D 0 0 0 c=J <br /> <br />Hood Suppression D 0 0 0 c=J <br /> <br />Fire Alarm Installation <br /> <br />Fire Pumps <br />Fire Works <br />Flammable Application- ANNUAL <br /> <br />Fuel Tanks <br /> <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 />D <br />B <br />D <br />D <br />D <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 Bum <br /> <br />Sparklers <br />Sprinkler System Installations <br />Standpipes (Sprinkler Sys) <br />Torch RoofingfTar Kettle <br />Waste Tire Storage ANNUAL <br /> <br />Other: <br /> <br />Valuation of Project <br /> <br />I <br />./').-1.'>. <br /> <br />I <br /> <br />~CJ1!~ <br /> <br />I Company <br />Registered <br />I License # <br />I Company <br />Registered <br />I License # <br />I Company <br />Registered <br />I License # <br />I Company <br />Registered <br />I License # <br />I Company <br />Registered <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 />Y/N <br /> <br />Fee Current <br /> <br />Y/N <br /> <br />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. Parcel # - obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />