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813-780-0020 City Of Zephychills Fire Fax-813-�80-0021 —
<br /> ' Permit Application
<br /> Date Receive�� ;~`�u# �V(s4- � - Phone Contact for Permjt ���
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<br /> Qwnez's h}ame � � Qwner's Phone Number �� �� �___�
<br /> Ovmer's Address ) ry, ru � d,
<br /> Fee Simple Titleholder Name Titleholder Phone Number C-� [� ��
<br /> Fee Simple Titleholdet Address
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<br /> Joh Address �Qf# 5���
<br /> Sub Division Parcel#
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<br /> � Bio-Hazard Waste Storage-ANNUAL � � Fumigation Tent »�-k.
<br /> Q Comm F�chaus#Kitchen HoodlDttc# � Hazardous Material(Tier tl ar F{Q Facility}Jtt+iNtlAL
<br /> � Controlled Bum a Hood Installation
<br /> � Emergency Generator e 30 kw � LPINatural�as-Installatian
<br /> Q Emergency Generator}30 kw � LP/Natural Gas-ANNUAL Sale
<br /> o ,Fre Protection Maintenance-ANNUA! �Places of Assembly-APiNUAL , `��
<br /> ❑� emi �Tn er �,�j'�/�
<br /> 3prinkler L7 L7 ❑ � Recreationa!Bum �� �
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers
<br /> Nood Gleaning � ❑ ❑ ❑ C� � Sprinkler Sys#em Insta!►a6ons
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> o Fire Aiarm Installation � Tarch Roofing/Tar Kettle
<br /> � Fire Pumps � Waste Tire Starage ANNUAL
<br /> � F3ammableApplication-ANNUA� �—r � Valuation of Project
<br /> � Fuel Tanks
<br /> � {�#�t�C;
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<br /> Gonlsactar / Company . �
<br /> Signature �o�-r--- ' Registered Y/N Fee Current Y/N '
<br /> Address license#
<br /> ELECTRICIAN Company ,
<br /> Signature Registered Y 1 N Fee Current Y 1 N
<br /> Address License#
<br /> PLUMBER Gompany -
<br /> Signature Regis#ered Y/N Fee Current Y/N
<br /> Address
<br /> Cicense#
<br /> MECHANICAL Company
<br /> Signature Registered Y I►U Fee CuRent Y 1 N
<br /> Address � License#
<br /> OTHER -
<br /> Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address
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<br /> Fit!out application comp3etely.
<br /> CMmer&Contractor sign back of applicatian,notarized(Or,copy of signed contract with owner)
<br /> tf over$2500,a Notice af Commencement!s required(Mechanicai work over$5400)
<br /> Suppty two(2}sets of drawings with applicable documentation
<br /> Allow 10-14 days for review after submittal date. Parcel#-abtained from Property Tax Notice(http://appraiser.pascogov.com)
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