|
f a�3-7ao-�o2o Cify af ZephyrhiHs Fire Fax-813-78d-4021
<br /> Permit Application
<br /> Date Received ;� � Phone Contact for Permit
<br /> rF:-���,_. -_ . ....:.._ u.. ..�_� - .M-�,. ..>>r.,�.e�_-��....a:v=:.�,..:«.r�:-�.=.:wi,�:�j;a�::,..t_,-F�:;,:5's;�:a.s,:�_: -.u._,.,.�.,...4.._.,F._._-�._,�'Y��•,_.u..j.. _�...:.r_�.e.c-��.:,4.:.eu,.�...�:_
<br /> Owne�s Name� � lers Phone Number �,, �V
<br /> Owners Address , �? '� " � � 1 '�� �6�
<br />, Fee Simple Titleholder Name 7itleholder Phone Number
<br /> Fee Simpte Tit{eholder Address �
<br /> _ " %:,R�' :f;i _ �y+✓�.?Y.`� rrn:tc, _ � - . .. �s+�;..^T w*.nr^sT�v� Y�G-�z- > 5=-M`^i'. +_
<br /> «,'.i:�.:.�"'_..'.'=Ts`.v.+<.+�.�._. ..:f..i�'. :.�:r:`!-+.. vNa' �""���'���-ef.a-r.����w ...i.'a«'%L�y .+u.-�'..Wb`3luiC.�-_<a�v'..:..r'.i��Y�1'i.w.c�._•• -r.�m'�.i.F+Y::ziw.,+1�'t.c.J...... .`.�-�."�"..w.:�...,[.,;�..v...,..,G:.w--cAo.
<br /> Job Address Lot#� ��
<br /> Sub Division Parcei# �
<br /> �r-�--� ��_-.�.:,.,.:,.�:-..
<br /> �.:;a,:,....5."&ti:�.�<t:2.u.<<':a':�...F'..�.._..<..�.z;:,,,.�,�'�"�.vu.>,_._.""��.m">.�...<-�`�:�:.''[.'n.':::?:;�.'�.:.�%nt�.r'.�:'.....�.E.�...:"35'_:?t'�e_s:.L'�.:�r<d.'a."_=`r�:�'�.�'-'>...'w''.:��.n'�:.,....._�.�.........�__....... ..:a�w.: 'Y'.�
<br /> � Bio-Hazard Waste Storage-ANNUAI. � Fumigatian Tent
<br /> � Camm E�chaust Kitchen Haod/Duct � Hazardous Material(Tier II or RQ Facitity}ANNUAL
<br /> � Controlled Bum - � Hood Installation
<br /> '� � Emergency Generator<30 kw Q LPtNaturat Gas-InstaNation . ���
<br /> � Emergency Generator>30 kw PlNatural Gas-ANNUAL Sale �(i-�'�]
<br /> � Fire Protecfion AAaintenance-ANNUAL � Places of Assemb(y-ANNUAL� �'�
<br /> ❑� emi �n i er - ----�.. ..
<br />�� Sprinkler CI O CI Recreafianal B'um
<br /> Fire Alartn � ❑ ❑ ❑ � � Sparkiers `�� �
<br /> � (
<br /> Haod Glsa�ing � t� � C] � � Spdnkler System Installations
<br /> Hood Suppression � ❑ d ❑ � � Standpipes(Sprinkler Sys)
<br /> � Fire Alarm InstallaGon � Torch Roofing/Tar Kettte
<br />' � Fire Pumps , � Waste Tire Storage ANNUAL
<br /> � F{ammable Appiicakion-ANNUAL �_—• � Valuation of Project
<br /> � Fuel Tanks
<br />' [� Uther:
<br /> .;:Rx.:1e"...: :`•"'"'.:.-,�"aVT "' �.��:,.."_ ..�"^"#.'_'v`:�.:�.,'�.'w�"'"-:w.`.""e» _-_ ..a�-z���.,>.�..., r_-,�..-...y-a.-"'a--�.�..,r�x-�v-�.e.M.,-,...
<br /> G".:::�.» ..f"",..-".•� ._.,.- �:'�f� �.'.�`„-"..�:._ .�,�.s......�� - v,.,�.+..,�_...,.-,_.:,...,....-,...s�..}W..— - .�`--..�...--.....�».....i.._._...a..<-�_.�.t.........._....�....��.�.,.�
<br /> Gontractor • � . Company
<br /> Signature � Registered Y/N Fee Current Y/N ,
<br /> ' Address License# r
<br /> ELECTRICIAN Gompany
<br /> S3gnature � Registered Y/Itl Fee Cusrenf Y/N
<br /> Address License# �
<br /> PLUMBEF2 Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> MECHANICAL C��Pa�y
<br /> 8ignature Registered Y/N Fee Current Y 1 N i
<br /> Address License# '
<br /> I
<br /> OTHER Company
<br /> Signature Registered Y!N Fee GuRant Y/N
<br /> Address License#
<br /> �.»"��y+e��.'..'+�.°.�.:W�..n�y' .1.�'tLY ..�_�.._�.Awva'.3'�....««�...:5',uv�:L.......�w..��4±:i..i+:«.'.✓.�...i..........n:.�.....�.s..N.����i.'..L:�..q-.t:.:f.Y........�a:Y"G::,.:-�_.�.r..r...�.a...a....-.:..J.en..v....-...7a��...t.u_
<br /> ._� r.....K.....r 'L'+a...,n..a'1.�..'.�,� n
<br /> �:!:.'Tn^..:s wR:.v..`a'i:�
<br /> Directions:
<br /> Fi1t out appiication completely.
<br /> Uwner&Contractor sign back of appUcation,notarized(Or,copy of signed contract with owner)
<br /> i�over$2500,a htotice of Gommencement is required{Mechanical work over$5000} �
<br /> Supply iwo(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 />
|