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813-780-0020 City Of ZephyrhiUs 'Fire Fax-813-780-0021 . Permit Application _ . Date Received 1 Phone Contact for Permit __--- I I L s l i Owners Name I /7444 /45/ uw te I Owner's Phone Number 1 ?0 1 , /c— Owner's Address I S 6,51-- L 3 L tz }5 I Fee Simple Titleholder Name I I Titleholder Phone Number I 1 1 I Fee Simple titleholder Address 1 I Job Address I I Lot # I Sub Division I I Parcel # I I ED Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent a Comm Exhaust Kitchen hbodlDuct n Hazardous Material (Tier II or RQ Facility) ANNUAL n Controlled Burn n Hood Installation El Emergency Generator < 30 kw ED LPMaturaI Gas - installation a Emergency Generator > 30 kw n LP/Natural Gas - ANNUAL Sale 0 Fire Protection Maintenance - ANNUAL In Places of Assembly- ANNUAL MI ®® •t .ii^ Sprinkler ❑ ❑ ❑ ❑ n Recreational Bum Fire Alarm El ❑ ❑ ❑ I 1 0 Sparklers Hood Cleaning E ❑ a ❑ 1 1 n Sprinkler System Installations Hood Suppression ❑ yl ❑ I 1 n Standpipes (Sprinkler Sys) ED Fire Alarm Installation n Torch RoofmgfTar Kettle ` Fire Pumps n Waste Tire Storage ANNUAL Fire Works Flammable Application- ANNUAL I Valuation of Project Fuel Tanks 0 Other. I I Contractor Company I Signature Registered Y / N I Fee Current I Y/ N I Address I I License # I ELECTRICIAN Company I Signature Registered Y/ N 1 Fee Current I Y/ N I Address I I License # I PLUMBER Company I Signature Registered Y/ N 1 Fee Current I Y/ N j Address 1 I License # ( I MECHANICAL Company I signature Registered Y/ N _I Fee Current I YIN 1 Address I 1 License* 1 I OTHER Company ' 4 �Be� L Signature Veer e ,G'l.Kl fit/L- Registered Fee Current Address 117MW ref is/P License # j e - a Directions: Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) if over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (httpJlappraiser.pascogov.com)