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813-780-6020 Gity of ZephyrF�i(Is Fire Fax-813-780-4021
<br /> �r- , . � Permit Application
<br /> Dake Received �_� Phone Contact for Permit �.,��, �
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<br /> Owner's Name ,�G.r�i Owne�s Phone Number �� C� ��
<br /> ow„ers Aaa�ess
<br /> �"/ � �°s L--. ��S��
<br /> Fee Simple Titleholder Name Titleholder Phone Number t� C� �
<br /> Fee Simple Titleholder Address
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<br /> JobAddressY � Lot# �
<br /> Su0 Division Parce!#
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<br /> Lyp".L�'_M�p{��-j�� Bio-Hazard Waste Storage-ANNUALLL.�..,__......�._.__.--- - --� � Fumigation Tent
<br /> � Comm Exhaust Kitchen Hood/Duct � tiazardous Dfiaferia{(Tier 11 or RQ Fac9lify}ANNUAL
<br /> � Controlled Bum � Hood Installation
<br /> � Emergenoy Generator<30 kw Q lP/Naturai Gas-insta(lation
<br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL 8ale
<br /> � Fire Protection Maintenance-ANNUAL Places of Assembly-,4idNt7AL
<br /> �trT] emi � t er / �� /'
<br /> Sprinkler � O [� Q � Recreaf'sanal Bum _+� �f f�
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers
<br /> Hood Cleaning � C� Q � � � Sp�nkler System Enstallatians
<br /> Hood Suppression � ❑ ❑ ❑ C] � �tandpipes(Sprinkler Sys)
<br /> � Fire Alarm Installation � Torch RoofingfTar Ketfte
<br /> � Fire Pumps Waste Tire Storage ANNUAL
<br /> � Fiammabie Appiication-ANNUAL �!•—� Vaivation of Project
<br /> � Fue!Tanks
<br /> QOther:
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<br /> Contractor � /� Compar�y
<br /> Signature � � / �� Registered Y/N Fee Current Y/N
<br /> Address �������#
<br /> ELECTRICIAN Company
<br /> Signature Registered Y 1�l Fee Gurrent Y 1 N
<br /> Address License#
<br /> PLUMBER ComR��Y
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address �icense#
<br /> MECHANICAL Company
<br /> Signature Registered Y/N Fee Current Y 1 R1 `°
<br /> Address License#
<br /> QTHER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address �icense#
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<br /> Directians: - . _ __<........,�,._---_._._._d,.� __
<br /> Fifi out application completely.
<br /> Qwner&Contractar sign back of application,notanzed(Or,copy of signed contract with owner)
<br /> 1f over$2500,a Notice of Commencement is required{Mechanicai wark over$5000}
<br /> Supply two(2)sets of drawings with applicable documentation
<br /> Allow 30-14 days far review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
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