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T)VV <br /> kr 9 9 Y <br /> 813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> .A <br /> Owner's Name U es th-g-F Owner's Phone Number <br /> Owner's Address F <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> r--n. <br /> Job Address POA') Y'd Lot# <br /> Sub Division Parcel# <br /> F-1 Bio-Hazard Waste Storage-ANNUAL Fumigation Tent <br /> F-1 Comm Exhaust Kitchen Hood/Duct F-1 Hazardous Material(Tier 11 or RO Facility)ANNUAL <br /> 0 Controlled Bum = Hood Installation <br /> F-1 Emergency Generator<30 kw LP/Natural Gas-Installatior <br /> Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL <br /> fUny rem— An MT—er—1 Recreational Burn Sprinkler M 0 0 0- F <br /> Fire Alarm F] 0 0 0 Sparkle' <br /> Hood Cleaning 0 11 0, Sprinkler System Installations <br /> Hood Suppression E-1 11 0 o El Standpipes(Sprinkler Sys) <br /> MR Fire Alarm Installation Torch RoofingfTar Kettle <br /> = Fire Pumps Waste Tire Storage ANNUAL <br /> HFlammable Application-ANNUAL Valua roject <br /> Fuel Tanks <br /> Other: )WW P.+I-er- 1^4V <br /> Contractor Company #Ire <br /> , <br /> Signature Registered N Fee Current Y 7 <br /> Address IW—b Mr)-%/ iPWIP, 1pr-r-* Q ?*2 4)7-7 License# I a Usgdy 13 <br /> I <br /> ELECTRICIAN Company <br /> Signature Registered I Y/N Fee Current YT—N <br /> I <br /> Address License# F <br /> PLUMBER 7—� Company I <br /> Signature Registered Y/N I Fee current Y TN <br /> Address License# <br /> MECHANICAL company <br /> Signature Registered Y/N Fee Current YTN <br /> Address LicenS6# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current L_]L/N <br /> Address License <br /> Directions: <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$6000) <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 />