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• <br /> . rfisa8o -aozo City ofZephyrhiiis'Fire: Fax- 813-780 -0o,,i <br /> Permit Application <br /> Date Received , :- Contact for Permit <br /> Owner's Name ■ i 1 <br /> iv.A C I 1 V Owner's Phone Nu <br /> ,.e �\ 1 t^ (,\ l � ,,v,.} } N � Ln hl! Number k <br /> Owner's Address 1 S Li 3 Q 1 '" 5 1 <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee Simple Titleholder Address 1 <br /> Job Address 50. '3q 1 c t • 1 e ( r 1-. ); Li l \s Lot* <br /> Sub Division • Parcel # <br /> 1 Bio-Hazard Waste Storage - .ANNUAL n Fumigation Tent , <br /> Comm Exhaust Kitchen-Hood/Duct • n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> FT Controlled Bum n .Hood Installation <br /> • In Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30•kw n LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL • 1 '1 Places of Assembly-ANNUAL . <br /> •'i • f bemi I ®' Other '' <br /> Sprinkler n ❑ ❑ ❑ • 1 1 Recreational Bum <br /> • Fire Alarm E . ❑ ❑ ❑ J n Sparklers <br /> Hood Cleaning ❑ p <br /> ° 17 1 I n SprinklerSystem Installations <br /> Hood Suppression ❑ ❑ ❑ .1 ( n Standpipes (Sprinkler Sys) • ' <br /> • <br /> n Fire Alarm installation n Torch Roofing/Tar Kettle <br /> El Fire Pumps ' n Waste Tire Storage ANNUAL <br /> Fire Works <br /> FR Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks -1_ _ D • <br /> 0 Other: _ II <br /> Contractor Company C_ 7 <br /> Signature J . Registered �� Y /.N Fee rrent Y / <br /> Address License # <br /> ELECTRICIAN Company . <br /> Signature Registered Y / N 1 Fee Current Y / N - <br /> Address 1 1 License* <br /> PLUMBER Company <br /> Signature Registered Y / N j Fee Current 1 Y / N <br /> Address 1 • I License # 1_ <br /> MECHANICAL Company <br /> Signature Registered Y / N Fee Current Y N <br /> Address 1 • License # <br /> OTHER Company <br /> Signature Registered Y/ N j Fee Current 1 Y / N <br /> Address License # 1 <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 submtttal date. Parcel #- obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />