Laserfiche WebLink
813 -i 80 -0020 City of ZephyrhillS Fire Fax -813- 780 -0021 <br /> Permit Application <br /> Date Received J Phone Contact for Permit <br /> Owner's Name Z:ZeiIC."A 9ep� Owner's Phone Number �/3 zeS 0.3 7 <br /> Owner's Address 378/5 /334 / ire iti <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address 3 7Fz5 /sew "ire G(/ <br /> Lot # <br /> Sub Division Parcel # <br /> .. ,.e.... Frt ,. ..., i. ... ........ ,...mel. .....« .. ...<. .. ... a .... ., .. <br /> I Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw I I LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> iLitrlyl (Semi) FAFFI Other <br /> Sprinkler R ❑ ❑ )M¢ n Recreational Bum <br /> Fire- I I Sparklers <br /> Hood Cleaning ❑ ❑ ❑ I I n Sprinkler System Installations <br /> Hood Suppression n ❑ ❑ ❑ I 1 n Standpipes (Sprinkler Sys) <br /> I —I Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> I I Fire Pumps n Waste Tire Storage ANNUAL <br /> I I Fire Works <br /> Flammable Application- ANNUAL <br /> 1 I Valuation of Project <br /> n Fuel Tanks <br /> n Other: I <br /> Contractor Company <br /> Signature Registered Y / N I Fee Current I Y / N j <br /> Address I I License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N j Fee Current I Y / N I <br /> Address ( I License* <br /> PLUMBER Company <br /> Signature Registered Y / N I Fee Current I Y/ N I <br /> Address I I License # <br /> MECHANICAL Company <br /> Signature Registered Y / N I Fee Current I Y / N j <br /> Address I License # I <br /> OTHER Company <br /> Signature �� <br /> 9 Registered Y / N I Fee Current I Y / 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 $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 />