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813-780-0020 City of Zephyrhifs Fire Fax - 813- 780-0021 <br /> Permit Application <br /> ate Received IF Prone Contact for Permit r*1' [.. 1.1.1. <br /> amens Name Yv ` y\d y5 I Owner's Phone Number I 1) 1 1 1 1 1 <br /> wner's Address <br /> ee Simple Titleholder Name Tit eholoer PpOne Nu mb; 1 la ( 1 } 1 <br /> se Simple Titleholder Address I <br /> 3b Address S G51 G. u 7 ephv r 1■si 11 S f L •59 0 Lot <br /> ub Division Parcel # 1 <br /> . , _ ..:.. .... .. . -_ • _- _ ... <br /> Bio-Hazard Waste Storage - ANNUAL o Fumigation Tent <br /> E . Comm Exhaust Kitchen Hood/Duct Hez ardoue Material Tier D or RO Facility) ANNUAL <br /> Controlled Bran = Hood Inst ii•Uon <br /> - <br /> Emergency Generator < 30 kw = LPeNauxai Gas ,,/ <br /> tiii Emergency Generator > 30 kw LP/Natural Gas- ANNUAL Sale ` n A � <br /> /.7 ) Fire Protection Maintenance - ANNUAL. Paces of Assembiy- ANNUAL D �L g <br /> Sprinkler E % ❑ Recreatiane! Burr /( <br /> Fire Alarm Ej ❑ ❑ ❑ Sparklers l� <br /> Hood Cleaning ❑ ❑ ❑ Sprinkler System insiallauons <br /> Hood Suppression f ❑ 0 ❑ Standpipes (Sprinkler Sys) <br /> ED Fire Alarm Installation Torch Root ng /Tar Kettle <br /> 1 Fire Pumps 3 -4 iv ,. Waste Tse Storage ANNUAL <br /> Rowe <br /> Fire Works 4. s <br /> Flammable Application- ANNUAL 1 1 Valuation of Project <br /> r..... <br /> Fuel Tanks <br /> Ci Other: <br /> c ontractor /. f 1 company 1•ijl rrimti�itroo z�la. f <br /> signature �!�l •L ,.�.r Registered Y / N Fee Current / N <br /> r iaitk' <br /> Address .lkTISMJa3:111111, • • 4.iWiti ' 3 i5 tcense# I <br /> ELECTRICIAN I Company <br /> Signature i Registered ) Y N 1 Fee Current , Y 1 N I <br /> Address I s License # f <br /> PLUMBER Com <br /> Signature Registered Y/ N 1 Fee Current I Y/ N I <br /> Address I 1 Limns* # I <br /> MECHANICAL 1 �` t <br /> Signature 1 Registered Y/ N ( Fee Currant ` Y 1 N <br /> Address 1 1 License # 1 1 <br /> OTHER I Company <br /> Signature 1 Fu visional Y N 1 Fee Current ( Y/ N 1 <br /> Address i License # <br /> rar�na► .. <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign heck ci application:, notarized (Or. copy of signed contract wttb owner) <br /> tf over 52800, a Notice of Commencement is required (Mechanical work over 55000) <br /> Supply two (2) sets of drawings with applicable documentation iser.peacogov.com) <br /> Allow 10 days for review after subrn)tiai date. Parcet # - obtained from Property Tax Notice (http / s /app <br />