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813-780-002f !� ,�/ City of Zephyrhilis Firms <br /> Permit Appilcation Fax -81 a 780 0021 <br /> Date Received Phone Contact for Permit_ <br /> Owner's Name Owns Phone Number ‘I ( ) <br /> Owners Address <br /> Fee Simple Titleholder Name , Titleholder Phone Number ( ' ) ( `) ( I <br /> Fee Simple Titleholder Address I <br /> Job Address 5�[� G-(111 %\i> �? Py <br /> k r \-. ; s L 33 `4O v)e (No o # <br /> Sub Division Parcel # <br /> ED u• Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood/Duct Q Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> E Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw 1'n LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Piaces of Assembly- ANNUAL <br /> leiiim !SemrI ® • - <br /> Sprinkler C 0 0 0 Recreational Bum /; / <br /> Fire Alarm El 0 ❑ ❑ n Sparklers 1 / y <br /> Hood Cleaning II 0 ❑ ❑ C n Sprinkler System Installations <br /> Hood Suppression C D D D I 1 n Standpipes (Sprinkler Sys) <br /> a Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> -y o 4 Waste Tire Storage ANNUAL <br /> Fire Pumps M t1 <br /> Fire Works <br /> Flammable Application- ANNUAL I ! Valuation of Project <br /> Fuel Tanks <br /> C Other: 1 <br /> Contractor ; company 50J�hZC 11 C ∎rg syS * o• S Z� <br /> Signature �, / - J ,� I Registered Y / N Fee Current Y / N 1 <br /> sw <br /> Address ��n� i ;�� ��•� Ei 7 I License # j <br /> ELECTRICIAN Company <br /> Signature Registered Y / N I Fee Current L Y/ N I <br /> Address 1 I License # I I <br /> PLUMBER Company <br /> Signature Registered Y/ N I Fee Current Y / N <br /> Address I 1 License # <br /> MECHANICAL Company <br /> Signature Registered , Y / N 1 Fee Current 1 Y/ N j <br /> Address 1 I License # I <br /> OTHER Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N j <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 55000) <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 />