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JUN /30/2003/MON 11:34 AM ZEPHYAHILLS BUILDING FAX No, 313 -730 -0021 P. 001 <br /> 813.7.80-0020 City ofZephyrhilis Fire' �� Fax- 1313 -780 -0021 0 <br /> Permit Application - = <br /> Date Received Phone Contact for Permit a .+► 3 1 a ;• • <br /> Owner's Name . • • • • Y7 1 a • r' 4 g Owner's Phone Number � � <br /> Owner's Address ' Ale a • 1 `I 1 <br /> • <br /> • <br /> Fee Simple Titleholder Name Titleholder Phone Number r <br /> Fee Simple Address r <br /> Job Address I JIM) •1 N oh . i- • 4 Lot# <br /> Sub Division �. Lb /L • Parcel # . .. •_. -_ - , tst- _0), .s <br /> ' ag <br /> r---1 $lo+iszard Waste Storage = ANNNUAL. . =1 Fumigation Tent <br /> n Comm Exhaust }Groh en Hood/Duct Ei Hazardous Material (Tier 11 or RQ Facility) ANNUAL <br /> Controlled Bum Hood Installation <br /> ED Emergency Generatar'< 30 kw LP/Natural Gas- Installation <br /> • <br /> El Ernergeney Generator > 30 k . = LP/Natural Gas - ANNUAL Sale • • <br /> • fl - Fire Protection Maintenance - ANNUAL • MI • • Places of Assembly- ANNUAL " <br /> L <br /> a .Seal[ ��;,-•• I °trier • ' /// • <br /> Spookier 0 O 0 Recreational Bum <br /> Fire C <br /> Alarm E ° r'7 :C.1 r I Sparklers . <br /> Hood Cleaning 0 D o L 1 Sprinkler System Installations <br /> Hood Suppression ❑ 0 0 0 I . I Standpipes (Sprinkler Sys) • . <br /> El Fire Alarm installation 0 Torch Roofing/Tar Kettle <br /> n Flre Pumpa • = Waste Tire Storage ANNUAL • . • <br /> H ( Fire Works S <br /> Flammable Application- ANNUAL - Valuation of Project • <br /> = Fuel Tanks . • . . <br /> El other 1 . . <br /> Contractor Company 1 <br /> Signature Registered I ' Y / N ( Fee Current . I Y / N <br /> Address 1 . I ' _.. License # .L_ _ _ 1 . .. <br /> ELECTRICIAN company <br /> • <br /> Signature Registered Y/ N 1 Fee current 1 Y/ N <br /> • Address 1 . I . License # L — T . <br /> PLUMBER . Company • <br /> Signature - - Registered YIN 1 Fee current • Y / N 1 <br /> Address • License # • <br /> MECHANICAL ' Company • • I <br /> Signature ' . Registered Y / N 1 Fee Current - I Y / NJ • <br /> • <br /> Address _ .License# • I 1 <br /> OTHER . � : Company '-- 0 .I. l e 4. r 4 �i!U] i1 k/ <br /> Signature �� Registered Irian, Fee Cu nt WJ E <br /> • Address Ltiv �.3.L�%��!1 r` `�`�i'.T IMItiTR'! Ucenae# . :L�! l.�d'.V � a�� <br /> z.,. _ . <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 dacumentation . <br /> Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (frttpJ/appralser.pascogov.ccm) . <br /> • <br /> • <br /> i <br /> • <br />