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813-780-0020 City of ZephyrhiilS Fire Fax-813-780-0021 <br /> Permit Application <br /> i <br /> Date Received � Phone Contact for Permit - <br /> �_- <br /> Owners Name n n e 12 Ift Owner's Phone Number <br /> Owner's Address .- P *� _ Y L S f0 k&_ 3 35^ <br /> Fee Simple Titleholder Name F Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> r - <br /> Job Address <br /> Lot# <br /> Sub Division Parcel# <br /> o Bio-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> Comm Exhaust Kitchen HoodlDuct Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> oControlled Burn Hood Installation <br /> Emergency Generator<30 kw LP/Natural Gas-Installation <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> QFire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> try emi Fn-q MtTe-F-1 <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ Sparklers <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> Fire Alarm Installation Torch Roofing/Tar Kettle" <br /> Fire Pumps a W to„T#e$torag NNUAL <br /> ❑ Flammable Application-ANNUAL ,j Valuation of Project <br /> ❑ Fuel Tanks <br /> QOther: <br /> Contractor Company l <br /> Signature Registered Y F e Current / <br /> Address License# <br /> ELECTRICIAN Company ( C (C es <br /> Signature Registered Y/N Fee Current Y/N <br /> Address ( rj r "~ t License# ' Q <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y!N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> Directions: <br /> t <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(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 />