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e�3-�iso-oozo City of Zephyrhilis Fire Fax-813-780=0021
<br /> , Permit Application
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<br /> Owner's Na,me V � � /�/ Owner's Phone Number C_��i (� �� �1r�
<br /> Owner's Address � �.�rwlv V (�l�7'� �^ ��� ��S
<br /> Fee Simple Titlehi Ider Name Titlehoider Phone Number �� �� ��
<br /> Fee Simple Titleh Ider Address
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<br /> Job Address �Lat# ��
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<br /> Sub Division Parce{#
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<br /> � Bio-Hazard Waste Starage-ANNUAL � Fumigation Tent
<br /> �) Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II ar RQ Facility)ANNUAL
<br /> �� 1"'nntrnllarl Gi. �
<br /> r , Haod Installation
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<br /> ` � Emergency Generator<30 kw � LP/Natural Gas-Installation ;,:
<br /> ; Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale �
<br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL
<br /> � emi � t er �
<br /> Sprinkier � ❑ ❑ ❑ ;� Recreafionai Sum J ��c
<br /> Fire Alarm � ❑ ❑ ❑ '� Sparkiers
<br /> � � � ` �-
<br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations
<br /> Hood Suppressian � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> Fire Alarm installation � Tarch Rooflng/Tar Kettle •
<br /> � Fire Pumps � Waste Tire Starage ANNUAL
<br /> � FlammableApplicatian-ANNUAL ����, Valuatian of Project .
<br /> Fue!Tanks
<br /> � Qther.
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<br /> Contractor ( Company
<br /> Signature Registered Y/N Fee Curzent Y/N
<br /> Address C License#
<br /> ELECTRICIAN� Company
<br /> � Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> PLUMBER Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> MEGHANICAG Campany
<br /> Sig�ature Registered Y/N Fee Current Y/N
<br /> Address License#
<br /> OTHER Gampany
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address �-- t�icense#
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<br /> Directtons: �
<br /> Fill out application completely.
<br /> Owner i�Cantractor sign back of application,notarized(Or,copy of signed contract with owner)
<br /> If over$2500,a Notice of Commencement is required(Mechanical work ouer$5000}
<br /> Suppiy twa{2}-sets of drawings with appiicabie dacumentation
<br /> Allaw 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com)
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