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813- 780 -0020 City of.Zephyrhiils Fire- rdx -o i o 04 I . <br /> Permit Application 1 4,' 9 . _ <br /> Date Received - Phone Contact for Permit <br /> Owner's Name 7P ON'''I..\{ \\ S t 1 ILL 1 Owner's Phone Number 1 1 I <br /> Owner's Address tl 2`1 ky e ' A U3 ' � - l tl ', / t - <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address I <br /> Job Address 1 C 6 IUCt � 7 - - I It H / PC Lot # <br /> Sub Division Parcel # <br /> F Bio- Hazard Waste Storage - ANNUAL a Fumigation Tent <br /> E Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum a Hood Installation <br /> a Emergency Generator < 30 kw = LP /Natural Gas - installation <br /> E Emergency Generator> 30 kw = LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> man mal WA Uther <br /> Sprinkler ❑ ❑ n Recreational Bum <br /> Fire Alarm 0 ❑ ❑ ❑ I I I 1 Sparklers <br /> Hood Cleaning El ❑ ❑ ❑ I I I Sprinkler System Installations <br /> Hood Suppression E ❑ ❑ ❑ I I Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation a Torch Rooting/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application - ANNUAL ( 1 Valuation of Project <br /> Fuel Tanks <br /> Q Other: I J <br /> Contractor <br /> cvAiiik � � Compan A_ ( Q Signature � ' _ Registered m7" Fee Current Y / N <br /> Address �1■ ���lik f•, License # ( UNA k70( - )011 ■ci <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y/ N I <br /> Address e o. , . , ; ' I License # <br /> PLUMBER ,( k u:'"* - Company <br /> Signature il „r * Registered Y/ N I Fee Current 1 Y/ N <br /> Address <br /> I License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y / N <br /> Address <br /> 1 License # <br /> OTHER <br /> Company <br /> Signature Registered Y/ N 1 Fee Current I Y/ N j <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 $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 (httpJ /appraiser.pascogov.com) <br />