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813780 -0020 City of.Zephyrhilis Fire Fax - 813780 -0021 <br /> 'Permit Application <br /> Date Received <br /> . ..Mx� -.N .. . _. <br /> Phone Contact for Permit <br /> Owner's Name 1 1 Ch M S Sit t(7R.I LC. Owner's Phone Number I <br /> Owner's Address /% D'' C:a 1 1 I-u 6 eph , 'flyt t.8 a F4 a ?rile <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitleholder Address I <br /> . <br /> Job Address (/ 7 C et t( IQ <r V to 76 y c I41 L Lot # <br /> Sub Division / Parcel # <br /> I-I 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 /> Controlled Burn I Hood Installation <br /> n Emergency Generator < 30 kw l 1 LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw LP /Natural Gas - ANNUAL S <br /> 1 - 1 Fire Protection Maintenance - Places of Assembly - ANNUAL <br /> .. ..1 er (a <br /> Other ( �0 ; <br /> Sprinkler E ❑ ❑ ❑ n Recreational Bum <br /> Fire Alarm ❑ ❑ f 1 n Sparklers <br /> Hood Cleaning ❑ *1 I n Sprinkler System Installations <br /> Hood Suppression Li G. ❑ ❑ ❑ I I n Standpipes (Sprinkler Sys) <br /> I Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> = Fire Pumps FT Waste Tire Storage ANNUAL <br /> n Fire Works <br /> n Flammable Application- ANNUAL I I Valuation of Project <br /> n Fuel Tanks <br /> Q Other: I <br /> Contractor Company rI ?uNS 1 p 'RES$ e.A /N <br /> Signature t�/ Registered Y / N Fee Current Y / N <br /> Address I License # I <br /> ELECTRICIAN Company <br /> Signature I Registered Y / N Fee Current I Y / N I <br /> Address I I License # I <br /> PLUMBER Company <br /> Signature Registered Y / N I Fee Current I Y / N I <br /> Address I . License # I <br /> MECHANICAL Company <br /> Signature Registered Y / N j Fee Current I Y / N I <br /> Address I I License # I <br /> OTHER <br /> Company <br /> Signature Registered Y / N Fee Current I Y/ N <br /> Address License # <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 submittal date. Parcel # - obtained from Property Tax Notice (nttp: / /appraiser.pascogov.com) <br />