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. 813-780 -0020 City ofZephyrhilis'Fre. <br /> Fax- 813-780-0021 <br /> Permit Application <br /> Date Received / - Phone Contact for Permit 4 " <br /> Owners Name �' / ( r <br /> T� h e I IA C C• r . . - _ Owner's Phone Number 18 1 3 1 J l <br /> 782 I s�[i� <br /> Owner's Address 38G.3.. s / <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address 1 <br /> Job Address . • l <br /> Lot # <br /> Sub Division • , Parcel # <br /> n Fumigation Tent . <br /> n Bio-Hazard Waste Storage - •ANNUAL <br /> • <br /> n Comm Exhaust Kitchen. Hood/Duct • n Hazardous Material (Tier it or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> • n Emergency Generator < 30 kw n LP /Natural Gas - installation <br /> n rgency Generator> 30 kw n LP /Natural Gas - ANNUAL Safe <br /> Fire Protection Maintenance - ANNUAL • • n Places of Assembly-ANNUAL <br /> mai ' TS'em1 ®' maam <br /> Sprinkler n ❑ ❑ ❑ MN n Recreational Burn <br /> Fire Alarm ❑ ❑ . _ n Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ 1 1 n SprinklerSystem Installations <br /> Hood Suppression E ❑ ❑ ❑ .1 I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> n Fire Pumps n Waste Tire Storage ANNUAL <br /> 1 Fire Works <br /> FR Flammable Application- ANNUAL ( Valuation of Project <br /> Fuel Tanks • <br /> n Other: 1 . <br /> Contractor ,� . Company �( ^-L �<' <br /> Signature �' Registered Y / N Fee Current Y / N <br /> Address W�/AiAl YMM. l - License* <br /> ELECTRICIAN Company . <br /> Signature Registered Y/ N I Fee Current J Y/ N j <br /> Address 1 J , License # 1 <br /> PLUMBER Company <br /> Signature Registered Y / N 1 Fee Current I Y / N <br /> Address 1 . <br /> License # <br /> MECHANICAL • Company <br /> Signature . Registered _ Y / N Fee Current 1 Y N j <br /> Address <br /> I • License # J <br /> OTHER <br /> Company <br /> Signature Registered Y/ N Fee Current J Y / N 1 <br /> Address <br /> License # <br /> Directions: <br /> Fit 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 wtth applicable documentation <br /> Allow 10 days for review after submtttal date. Parcel # - obtained from Property Tax Notice (h1tpJ /appraiser.pascogov.com) <br /> • <br /> • <br />