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s�3-780-002o C9ty of Zephyrhil{s Fire Fa�c-813-780=4421
<br /> , ,. Permit Application
<br /> Date Received ��—� Phane Contact for Psrmit ���_t._�.r.l—t
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<br /> .,__ ��., ��"°"`" _ ��_ py�,ne�s Phone Number � � ��
<br /> Owner's Name
<br /> Owners Address�
<br /> Fee Simple Titlehlolder Name Titleholder Phone Number �� � �
<br /> Fee Simple TitteEiolder Address
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<br /> Job Address / m�� Lat# �C�
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<br /> Sub Divisian Parcel#
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<br /> �
<br /> � Bia-Hazard Waste Storage-ANNUAL � Fumigation Tent
<br /> � Comm E�chaust Kitchen NoodlDuct � Hazardous Materia!{Tier 11 or F2Q Facility)ANNUA�
<br /> � Controlled Bum � Hood Installation
<br /> -' � Emergenay Generator<30 kw � LPIRIatural Gas-tnsta]lation �
<br /> '� Emergency Generator>30 kw � LP/Natural Gas-ANNUAI.Sale n ��j., ����
<br /> � Fire Pratectiors Maintenance-ANNUAL � Places of Assembly-ANNUAL �Y;�/-�
<br /> � t y emi (A�n t er �I
<br /> Sprinkter � ❑ ❑ ❑ ,� � Recreationa!Bum
<br /> Fire Alarm � ❑ ❑ ❑ '� � Sparklers
<br /> � Nood Cieaning � ❑ Ci ❑ � � Sprinkier System installations �}
<br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) r�
<br /> ' � .���
<br /> �) Fire Aiarm Instaliafion � Torch RoofingiTar Kettie �
<br /> �� Fire Pumps • � Waste Tire Storage ANNUAL
<br /> (� FEammable Appiicatlon-ANNUAL C���� Valuation af Praject .
<br /> � Fuel Tanks
<br /> Q C)theC:
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<br /> Cantracfor i�,{���r,�/'�v l ?�`L(/t/ ,� Campany
<br /> Signature � ���j Registered Y/N Fee Current Y/N
<br /> Address 'j L.icense#
<br /> ELECTRICIAN ' Company
<br /> Signature Registered Y/N Fee Current Y/N
<br /> Address ''� License#
<br /> PIUMSER Company
<br /> Signature Registered Y/N Fee Ciirrent Y/N
<br /> Addtess � �icense#
<br /> MECHANICAL Company
<br /> Signature RegSsfered Y 1 N Fee Gurrent Y 1�1
<br /> Address � License#
<br /> OTNER Company
<br /> Signature Registened Y/N Fee Current Y/N
<br /> Address i� ticense#
<br />' Directions::���:�,_�__��_�_.:..�.._._�...............�_,,�L.s�,..�._��,..._��_�.M.�__._,w,�._�,»-.��...�"....._�_._�.��.._.._�__.r.��._..__.__.�<.. �___....�,.�.�.___='�?
<br /> II
<br /> FiII au#application completely.
<br /> Owner&Cantractor sign back of application,notarized(Or,copy of signed contract with owner)
<br /> f If over$2500,a Natice of Commencement is required{Mechanical wqrlc over$5040)
<br /> i Supp)y fwo(2}sets of drawings with appticable documentatian
<br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:Uappraiser.pascogov.com)
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