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813-780 -0020 City of Zephyrhilis Fire `/ (I" u Fax - 813 -780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> Owner's Name S"T.. - TV S �lit t4 CA.-' < L C) v t.. 4N. Owner's Phone Number jt 3 (-IS LA 3S t 9 <br /> Owner's Address % 53 4L4 11 }"` S" ze.p hy✓ \- ,.'\s 'PL "s354Z.- L432 - <br /> Fee Simple Titleholder Name • Titleholder Phone Number <br /> Fee Simple Titleholder Address I I <br /> .z.�r'.,;.:'si'Pw°' —m -, ;,y. i"aN r s= k >: <imint; a,.' .. „,- -,„, -, ., s. .- k%ri eh > 4, Eai. ,,..-. ' . ° -- ,,, ,, , ".' ,; X4iNAI ' i ±i ' 41 ".,' sT '.:..»nvf;c�.i' , `tgVi. $ ac”; 74k #•.�. ..... a .. <br /> Job Address S3 4 ‘4/ i' " S i . "Ze t h 1 V4\ 1 \i„ L. - s t-12. - N 3 zl Lot # <br /> Sub Division Parcel # <br /> •a , sg.su;':'"",a''"^S' „?�Sb:' _ ;..F:� .«t- .°,`t:u�+.*r ..rcr _z sse..+ ,m,-r ;�;r:.:,z` a ..:.s: r �N ...:_�.�.�.rs.: -r`d, ..?a`t. -: : , a::.. t ,., c`Sas ^ r�.,i'.a"�t'.�....,w� w.`..: rvu.. um .$:.,....;:.,.- Zw€'z.suat.•.. <br /> I Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> FT Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> FT Controlled Bum Ti Hood Installation <br /> I - 1 Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> I I Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL / / <br /> IIutnyl ISemil LW Uther DWI `t- 1 tt / i� / 01 <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm I ( ❑ ❑ ❑ Sparklers <br /> Hood Cleaning ❑ ❑ I Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> FT Fire Alarm Installation n Torch Roofing/Tar Kettle , <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> I Fuel Tanks <br /> In Other: I I <br /> Contractor Y .-- r .�Cl r` Company (- ) V ,S --r w t 4.4— S" - 40%-r (; ik_ / -s. 'Yf <br /> Signature J � b Registered (YUN I Fee Current I Y / N 10X <br /> Address igs) 7 'Q J 1t c. ( ST. LQ43u (::, Lb4CtI Y License # I 1 P.D.) AO- <br /> ELECTRICIAN i —% 11 - LI 20 - (,7- 7._..1 Company <br /> Signature Registered Y / N I Fee Current I Y / N J <br /> Address I I License # <br /> PLUMBER Company I <br /> Signature Registered Y/ N I Fee Current I Y / N I <br /> Address 1 1 License # <br /> MECHANICAL Company I <br /> Signature Registered Y/ N I Fee Current I Y/ N <br /> Address I I License* I <br /> OTHER , Company I <br /> Signature Registered Y/ N 1 Fee Current I Y/ N 1 <br /> Address I 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 $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 />