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City ofZephyrhilisFire. Fax -813 -780 -0021 <br /> 813-780-00 Permit Application <br /> ,.._=t ,- Phone Contact for Permit I 1 _ <br /> .. .o0.. .. ...- 4..wt.— ... +....— .......... .... ... ...........,......� .. . ..:r...«., <br /> Date Received "` "' <br /> - -��� m�� ` ' Owner's Phone Number <br /> Owner's Name d u / " <br /> — <br /> Owner's Address I � • <br /> �Y <br /> Titleholder Phone Number <br /> Fee Simple Titleholder Name � <br /> • <br /> Fee Simple-Titleholder Address r °�"�� " —L - <br /> �;; ;.Y.. Y..,rw. _ �. ...: ' .. <br /> �. � ^r � v <br /> Lot # <br /> Job Address <br /> Parcel # <br /> Sub Division " <br /> z• a s t azard .c.,., r Fumigation Tent <br /> Bio- Hazard Waste Storage- ANNUAL I I Hazardous Material (Tier II or RQ ANNUAL <br /> FT Facility) <br /> Comm =jchaust Kitchen Hood/Duct = Hood Installation <br /> Controlled Bum <br /> 1 <br /> LP /Natural Gas - Installation <br /> Emergency Generator < 30 kw = LP /Natural " "Gas=ANDiUAI_ Sale <br /> 1 I Emergency Generator> 30 kw �. of Assembly - ANNUAL 1?0 <br /> 1 Fire Protection Maintenance - ANNUAL L <br /> )utnyl lsemi) Utner <br /> ❑ ❑ ❑ ❑ Recreational Bum <br /> Sprinkler (�� ./..' 1 ❑ ❑ ❑ 1 1 1 - Sparklers i <br /> Fire Alarm I 1 I u �" • <br /> Sprinkler System Installatio <br /> Hood Cleaning ❑ ❑ ❑ 1____ I <br /> Standpipes (Sprinkler Sys) <br /> Hood Suppression ❑ ❑ D <br /> 1 • 1 Torch Roo ing /Tar Kettle <br /> TT Fire Alarm Installation <br /> 1 Waste Tire Storage ANNUAL <br /> Fire Pumps <br /> Fire Works Valuation of Project <br /> I Flammable Application- ANNUAL 1111111111111111111 <br /> 1 1 Fuel Tanks <br /> Other: 1 <br /> 1 Company <br /> Contractor 1 Registered Y / N I Fee Current J Y / N <br /> Signature �� k.� .X OA ,[�i �, � . <br /> License # • Address 1 <br /> Company <br /> ELECTRICIAN Registered Y / N Fee Current Y / N <br /> Signature 1 <br /> Address 1 1 License # <br /> Company <br /> SL ature . Registered Y / N 1 Fee Current Y / N <br /> Signature I <br /> Address 1 I License # <br /> MECHANICAL <br /> l Company Y / N <br /> Registered Y / N Fee Current <br /> Signature <br /> Address! I - License # • <br /> OTHEP. 1 Company <br /> Registered Y / N 1 Fee Current Y / N <br /> Signature I <br /> Address <br /> 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 32500, a Notice of Commencement is required.(Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation Parcel # - obtained from Property lax Notice (httpJlappraiser.pascogov.com) <br /> Allow 10 -14 days for review after submittal date. <br />