Laserfiche WebLink
IIISFire Fax-813-780-0021 <br /> City ofZephyrh' <br /> s1378o o0zo Permit Application <br /> • Phone Contact for Permit <br /> Date Received w <br /> o I 1 1 <br /> i` S • S 0 4 4 di Owner's Phone Number - <br /> Owner's Name �� ' 3 ��'L <br /> Owner's Address t <br /> Titleholder Phone Number <br /> Fee Simple Titiehoider Name <br /> Fee SimpleTitleholder Address <br /> ,<:�.�w�,. «�: -,, ..,�., - ,..«._ . ,•,.�.�. � �, •...� Lot# <br /> Job Address parcel # <br /> Sub Division • . .• <br /> _: <br /> Fumigation Tent <br /> Bro-Hazard Waste Storage - ANNUAL 1-1 <br /> Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> E Comm Exhaust Kitchen Hood/Duct I I Hood installation <br /> 7 -Controlled Burn l i--'1 i LP/Natural Gas..lnstaliation <br /> Emergency Generator < 30 kw l r — j /Natural Gas - ANNUAL Sale <br /> Li Emergency Generator> 30 kw 11 )�I p laces of Assembly- ANNUAL <br /> n Fire Protection Maintenance - ANNUAL ii rr rr <br /> E=1 [w • J ner <br /> Recreational Bum <br /> Sprinkler � 0 0 <br /> Fire Alarm C j�'� <br /> rkl <br /> ❑ ❑ 0 0 u Spaers <br /> H C A <br /> D 0 0 C Sprinkler System Installations <br /> Hood leaning <br /> ❑ � � 0 Standpipes (Sprinkler Sys) <br /> Hood Suppression <br /> Torch Roofing/Tar Kettle <br /> Fire Alarm Installation I Waste Tire Storage ANNUAL <br /> FR Fire Pumps <br /> Fire Works 1111111111111111111111111 Valuation of Project <br /> Flammable Application- ANNUAL <br /> Fuel Tanks <br /> = Other: <br /> ;� f s�• -t.: -.;.,..�, N :... -.,:,v - Company <br /> Signature Contractor Registered Y/ N 1 Fee Current 1 Y/ N 1 <br /> • ' <br /> � License # <br /> I <br /> Address _.. <br /> Company <br /> ELECTRICIAN Registered Y/ N I Fee Current I Y/ N <br /> Signature <br /> License # <br /> Address l <br /> Company <br /> Signature J <br /> PLUMBER l Registered Y/ N Fee Current 1 Y/ N <br /> Address 1 f <br /> J License # Company , <br /> MEnatUre I ALI Registered Y / N I Fee Current Y / N <br /> Signature JI <br /> • License # l <br /> Address <br /> • Company <br /> OTHER • I Registered i Y/ N 1 Fee Current 1 Y/ N <br /> Signature <br /> • License I.w� =H:. <br /> Address <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract wtth 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 Parcel #- obtained from Property Tax Notice (http:!lappraiser.pascogov.com) <br /> Allow 10 - days for review after submittal date. <br />