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813 '80 -0020 City of.Zephyrhilis Fire Fax -813 -780 -0021 <br /> Permit Application <br /> Date Received � Phone Contact for Permit r✓ MO I <br /> v <br /> � <br /> Owner's Name I WC / / Z Z /f I Owner's Phone Number I p3 1 z 1 <br /> Owner's Address J ? 6A4 // / / &' <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitieholder Address <br /> Job Address Lot # <br /> Sub Division Parcel # <br /> = Bio-HazardWasteStorage - ANNUAL pi 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 I LP /Natural Gas - Installation <br /> n Emergency Generator > 30 kw r---1 LP/Natural Gas - ANNUAL Sale <br /> El Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> ILItriyl IST r.111 Other <br /> Sprinkler E ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm n ❑ ❑ ❑ I n Sparklers <br /> Hood Cleaning Ii ❑ ❑ ❑ 1 1 n Sprinkler System Installations <br /> Hood Suppression NI ❑ ❑ I 1 n Standpipes (Sprinkler Sys) <br /> El Fire Alarm Installation FT Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> El Fire Works <br /> n Flammable Application- ANNUAL I ( Valuation of Project <br /> n Fuel Tanks <br /> 0 Other: I <br /> Contractor Company <br /> Signature Registered Y / N 1 Fee Current I Y / N <br /> Address I I License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N 1 Fee Current I Y/ N <br /> Address 1 I License #. 1 I <br /> PLUMBER Company <br /> Signature ' Registered Y/ N I Fee Current I Y/ N <br /> Address I ( ' License # <br /> MECHANICAL Company <br /> Signature Registered Y / N 1 Fee Current I Y/ N J <br /> Address I I License # <br /> OTHER r p /17 62c/07-/ <� <br /> Signature 1 /l F Registered M Fee Current �a I <br /> Address O af� « ��1_`� . , .: License # Ri � I / ! ... lid' <br /> .4 < . <br /> rox <br /> Directions: <br /> • <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 submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br /> • <br />