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i iiiiT/02i"200? /TUE 11:27 AM ZEPHYPHILLS BUILDING FAX No, 813 - 780 — !l021 r, uui <br /> ez- 7saoo2o <br /> City ofZephyrhilisFire.• (( Fax -813 -780 -0021 <br /> Permit Application <br /> `yy •� <br /> Date � ived • �i�ir.7�� Phone Gorr <br /> tactfar• Permit <br /> Dat lZece .. , ..::. <br /> ,,, �' 1 Owner's phone Number <br /> /���' ► � , �� I__ <br /> owner's Name �l <br /> Rd. ' + S� � � �•� ✓rte - � . <br /> Owner's Address { 1 //0 ! S ill +t[:k r . �` I 1 J <br /> Titleholder Phone Number 1 <br /> Fee Slmpie Titleholder Name <br /> Fee Simple Titleholder Address <br /> t / / I-01# <br /> Job Address a/ NAP <br /> Parcel # <br /> ��f' <br /> Sub Division - , <br /> Fymigation Tent <br /> Bfo- Hazard Waste Storage - ANNUAL 1---] - Hazardous Material (Tier II or RQ Facility) ANNUAL • <br /> Comm Exhaust 14`tchen Hood/Duct • . . <br /> ILI Co El ntrolled Bum Hood Installation <br /> LP /Natural Gas - Installation • <br /> 7 Emergency Generator { 30 kw a • <br /> LP/Natural Gas- ANNUAL Sale • <br /> Emergency Generator > 30 kw r places of Assembly-ANNUAL <br /> n Fire Protection Maintenance- ANNUAL y y = <br /> .� 015741 a!n PE Utter El 1=1re Alarm Q 17 E2 . Recreational Bum <br /> L_ J 0 fl I "` 1_ 1 n Sparklers <br /> 1 1 ru-( <br /> I=1 ❑ fl C] Sprinkler System Installations. <br /> . <br /> Hood Cleaning <br /> Hood Suppression L � <br /> r1 ❑ p 0 Standpipes .(Sprinkler Sys) . • El Fire Alarm installation Torch Roofing/Tar Kettle <br /> • <br /> Waste Tire Storage ANNUAL <br /> Fire Pumps E=1 c <br /> Fire works Valuation of Project <br /> Flammable Application- ANNUAL . <br /> • <br /> Fuel Tanks • • T- _ . <br /> n Other . I ._ . <br /> 'r.r ComPa+Y /Z�`'����c��� <br /> Contractor ., , 1 Registered Mini Fee Current - rye <br /> Signature <br /> Address •— .License# <br /> CornpanY <br /> Signature <br /> nature <br /> EL IAi Registered Y /� . Fee Current l Y / N <br /> Address <br /> ` j Ucense # <br /> Company • I • <br /> PLUMBER Registered ) N F .Fee Current , Y / N ' 71 Signature <br /> License # . <br /> Address I .---- <br /> MECHANICAL Company <br /> . Registered Y / N 1, Fee Current ' Y / N J <br /> Signature <br /> - License # <br /> Address <br /> OTHI R <br /> Signature Company <br /> • Registered Y/ N ( Fee Current I Y/ N j <br /> - <br /> LIcenae #d <br /> Address • .- s -. -... _.,__....� <br /> Directions: <br /> Fill out application completely. of signed contract with owner) <br /> Owner & Contractor sign back of application, notartzed (Or, copy 9 <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. <br /> Parcel # - obtained from Property Tax Notice (httpJ /appraiser.pascog0v.ccm) <br /> • <br /> • <br /> . • <br /> 1 <br />