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8_.:, a8U -9O4r City of.Zephyrhilis''Fire.. Fax- 813-780 -0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> Owner's Name Zeiyel, // j ,/, 4/Za {,/pg <W ./1%k I Owner's Phone Number P73 I7 " Y3oc <br /> Owners Address 7 3S -0, ?,1 20/4,4/ /s �. <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitleholderAddress <br /> t s#�r =`�..'"a'&?.:fiac..��.u;.. ew:Y: **tkns z.;e: ...;z..,� - a: . . , , ..ra�r_�,s s. .,. ..,., ax.... _ ,- ., :..�;n...a.'??ta° c,.�as . .x.x.- :r3- n.^:•.�°' +, v;a mss.. <br /> Job Address Lot* <br /> Sub Division Parcel # <br /> a §?� ".4�.$x �e ��+:.'. .. �n�a ,:;� ,x >r3• ... N=,:� � -;�,nx .. e.. ... , nom„ -. �� - ,rtah.,. x,ws' ,a._ >� _., , ,,.:_ x .., ,,,:� ,.�,. -,-fin �, ...ems st�,.m. :us <br /> SR <br /> FT Bio- Hazard Waste Storage - ANNUAL n Fumigation Tent <br /> n Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> n Controlled Bum n Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale <br /> I Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> lUtrly1 Jbemi1 Wij Uther <br /> Sprinkler n ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I I 1 Sparklers <br /> Hood Cleaning E ❑ ,K ❑ I I I I Sprinkler System Installations <br /> Hood Suppression ❑ Ar ❑ I I n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation n Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Ij ---Ij Fire Works <br /> I Flammable Application- ANNUAL I I Valuation of Project <br /> n Fuel Tanks <br /> ri Other: I <br /> Contractor Company <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I License # <br /> ELECTRICIAN Company <br /> Signature Registered Y / N j Fee Current I Y/ N I <br /> Address I I License # I <br /> PLUMBER Company <br /> Signature Registered Y/ N J Fee Current I Y / N I <br /> Address I I License # I <br /> MECHANICAL Company I <br /> Signature Registered Y / N I Fee Current I Y / N <br /> Address I I License # <br /> OTHER Company ;- _ <br /> Signature 61--2- Re o Fee Curr' EVjIIIII1 <br /> Address <br /> License # S"'CJ 2 sr7 (y00 /�(YO <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> ff 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 (httpJlappraiser.pascogov.com) <br />