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813-780-0020 City of ZephyrhiEls Fire F�-sT�-�so-oo2� f <br /> i ' Permik Application <br /> Date Received � � Phone Confact for Permit �� C� � <br /> -------- --- -.. _..— --- - - - - - - - -- - <br /> . . ..- -� �- ___._---..._.__ _>_ _.________...__---.,...---- - � ---..,.._____..____ _ .__..__,__---____._. <br /> Owne�s Name .Y. - . "_-. ._...__--f--._�C�_� .--- - ---°�•- .f I Owne�s Phone Number � � � <br /> Ovmers Address � <br /> Fee Simple Titleholder Name Titleholder Phone Number [� � � <br /> Fee Simple Titlehalder Address � <br /> _.----.. .�._.:..— .-__ __ _ _.__ __..._ - -- — -- - - — - -- -- -- <br /> �_------'�- -_ �.. _ - - ---- - -- - <br /> Job Addsess - - - — -- - -- -- - - --- - -- - - m '"lot# C� <br /> Sub Divisio� Parcel# <br /> -- ____..,_...___.. . - __-__,n_.-,._..____ �._,__. <br /> ._ ._�,�.�,_�.__ <br /> �_.-.--_. �____._. ____..___.,�._,_ ,.__..__�...__.____..___.v....._.._.._.__._ ._�.__,..�._._�._..____ ...._v_._ __�._w.._.._._.,_.----y_._ __._..__ ___.....---_._.�__._._.r.__ <br /> � Bio-Hazard Waste Storage-ANNUAI. � Fumigation Tent <br /> � Gomm Eachaust Kitchen Eloodtduct � Hazardous Material{Tier iI ar RQ Facility}ANNUAL <br /> � Controlled Bum a Hood Installation <br /> � Emergency Generator<30 kw Q �P/Natura!Gas-Installatian <br /> � Emergency Generator>30 kw � �P/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNl1AI.. Q Places of Assemb(y-ANNUAL I <br /> tr y emi � t er .�� I <br /> Sprinkier � O O ❑ � � Recrea#iana!Bum '"� t ; <br /> J+ � � <br /> Fire Alarm � ❑ ❑ Cl � Q Sparklers ��1� I <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System installations ��� <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fre Alarm installation Q Torch RoofinglTar Kettle <br /> � Fire Pumps o Waste Tire Storage ANNUAL <br /> � Flammabie Application-ANNUAL �r— � Valuation of Projec# <br /> � Fuel Tanks <br /> Q C?fher: � <br /> ._ --- __�___�.�___..__=w.....____...�__�___�_._...._____,�....___<__�.___.._.��--t-��-----�..-------__-___�.�__.�.-..___.._.�_�__--�.��_.�_..�_..�._—.� <br /> I <br /> Contractor Company <br /> Signature Registered Y/N Fee Current �(/N <br /> Address ( �icense# <br /> ELECTRICIAN Company <br /> Signature Registered Y/Iti! Fee Current Y 1 R4 <br /> ' Address � License# <br /> P�UMSER Company <br /> � 8ignature Registered Y/N Fes Current Y/N <br /> iAddress � �icense# <br /> MECHANICAL Company <br /> Signature ftegistered Y 11V Fee Current Y 1 N <br /> Address � License# <br /> C7THER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> � Address <br /> � 4icense# <br /> �..:_----�.._. .___. _.._ -__---:-__.. � .:��,__._._._ __ .___..•-.._w.,.._..----_-...__.__.�,_... _ _._ .__., <br /> Directions: -- --- -- -------.,._ _. _. .-----._ _ __,_-._ .___-._..__ __._ . <br /> F's(I aut application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2540,a Notice of Gommencement is required{tvtechanica3 work over$50Q4) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days far review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.comJ <br /> � <br />