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813-780-0020 City of Zephyrhiils Fire r3=73g 0021 <br /> Permit Application <br /> Date Received <br /> r::.�......_.,.-,-,a__...K _... -,•-, _ _.._.�...�.._.,... � _ •:. - w�, - Phone Contact Permit <br /> Owners Name Owners Phone Number <br /> Owner's Address 57� ZW ti` m t t.t FL- 3 Y"4 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address 14330 .104 6+ �Z e A:II sY FR 3354� <br /> Lot# <br /> Sub Division Parcel# 4_t r„e oov <br /> z::__�...__.w.:._ ;_��;•�; _ _ _ _ s3 t� „ "lQ-o7yoo 0000 <br /> Bio-Hazard.Waste Storage-ANNUAL:_.___._. ti n�=Fumiga yo <br /> Tent <br /> Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier Il or RQ Facility)ANNUAL <br /> oControlled Burn F-1 Hood Installation <br /> Emergency Generator<30 kw ® LP/Natural Gas-Installation <br /> Emergency Generator>30 kw F-1 LP/Natural Gas-ANNUAL Sale <br /> Q Fire Protection Maintenance-ANNUAL = Places of Assembly-ANNUAL <br /> r yPe-RI Pn er <br /> Sprinkler ❑ ❑ 0 ❑ Recreational Bum <br /> Fire Alarm ED ❑ ❑ ❑ u Sparklers <br /> Hood Cleaning ❑ ❑ ❑ ❑ Sprinkler System Installations <br /> Hood Suppression El ❑ ❑ I:] C] F_� Standpipes(Sprinkler Sys) <br /> QFire Alarm Installation Torch Rooflnglrar Kettle <br /> Fire Pumps Waste Tire Storage ANNUAL <br /> Flammable Application-ANNUAL •'"�""' <br /> d7D Valuation of Project <br /> oFuel Tanks <br /> Other: <br /> Contractor Company W i' o <br /> Signature <br /> �"� "- Registered N Fee Current /N <br /> Address yq(b Pkw License# GCG142o1015L <br /> ELECTRICIAN Company <br /> Signature Registered YIN_j Fee Current IY/N <br /> Address License# <br /> PLUMBER <br /> Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered I Y/N Fee Current Y/N <br /> Address License# <br /> OTHER <br /> Company <br /> Signature Registered Y/N Fee Current <br /> Address License# <br /> Directions:' <br /> Fitt out applicationi completely. <br /> Owner&Contractor sign back of application,notarized(Or,Dopy of signed contract with owner) <br /> If over$2500,a Notice of Commencement Is required{Mechanical work over$5000} ?v'^_^ 5'_ _� <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice,,(http.4aARP tji,PDAIR$.4obov com). <br /> r �n•�, <br />