Laserfiche WebLink
813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Phone Contact for Permit <br /> Date Received <br /> �K <br /> Owner's Name .3 .I� �5 Owner's Phone Number <br /> Owner's Address rZ �S TQt�l4Cn= A 4�, <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address 3T l% Lot-* <br /> ;# <br /> Sub Division Parcel# �aa ZG_Z11 (06— 1��00 <br /> Q Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct = Hazardous Material(Tier It or RQ Facility)ANNUAL <br /> Controlled Bum ® Hood Installation <br /> QEmergency Generator<30 kw LP/Natural Gas-Installation <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale .1 <br /> Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> ❑FOBy [8—em-11 rKnT1 ter <br /> Sprinkler ❑ ❑ OF ❑ Recreational Bum <br /> Fire Alarm ❑ ❑ ❑ �� ❑ Sparklers <br /> Hood Cleaning ❑ ❑ ❑ C� ❑ Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> Q Fire Alarm Installation Torch Roofing/Tar Kettle- f; <br /> F7 Fire Pumps Waste Tire StorageANNUAL C�1 <br /> ❑ Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> 11 <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current LLY/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER �—r acw Company., <br /> Signature Registered Y/N Fee Current Y/N <br /> Address 1 , L. License# 7-1 <br /> Directions: a <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;Pplicabie documentation' <br /> Allow 10-14 days3or.review aftersubmittal.date: Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />