Laserfiche WebLink
813-780-0020 City of Zephyrhilis Fire rdx-. , o-, ov-vvc <br /> • <br /> Permit Application <br /> Date Received Phone Contact for Permit 9)3 (oz t 13s? <br /> Owner's Name lc( D QA tom- (n e:tweM _- & _) ki IC. Owner's Phone Number 1 <br /> Owners Address D. 13s m er mo v2. ZtrPf4•4R.t-ht.ts , PC- • 3 3 rya <br /> Fee Simple Titleholder Name Titleholder Phone Number , <br /> Fee Simple Titleholder Address <br /> Job Address 313 t 35 i(n('h".0 -t.'•r S @ ()AIM Zr4Pt+1- 'A.S. , PC- Lot # <br /> Sub Division 64 (,•( CV- x) id-S Parcel # ,,. 22, • L) • OD 10 •0 3900 • do bo <br /> Bio -Hazard Waste Storage - ANNUAL I Fumigation Tent <br /> I-I Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> El Controlled Burn n Hood Installation <br /> 0 Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> El Emergency Generator> 30 kw I LP /Natural Gas - ANNUAL Sale <br /> n Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL r y �/ <br /> 'berm � other / f <br /> Sprinkler Ib ❑ ❑ n Recreational Bum l <br /> Fire Alarm El ❑ ❑ ❑ 1 1 n Sparklers <br /> Hood Cleaning Ej ❑ ❑ ❑ 1 1 n Sprinkler System Installations <br /> H ood Suppression El ❑ ❑ ❑ 1 1 j Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation I Torch Roofing/Tar Kettle <br /> Fire Pumps n Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL /4> Z 5 • •00 I Valuation of Project <br /> Fuel Tanks <br /> n Other: I I <br /> Contractor ''" T 71'; Company Rp>aAA-", pia)" ,spQjr1tC( S, lac . I <br /> Signature --- 'Regictered d7/ N I Fee Current I QS 1 N <br /> Address ( I License # I y(, e, Li _O 1)%g °° I <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N I Fee Current I Y/ N_I <br /> Address ( I License # I I <br /> PLUMBER , Company <br /> Signature Registered Y/ N I Fee Current 1 Y/ N 1 <br /> Address I I License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current 1 Y / N I <br /> Address I I License # I I <br /> OTHER Company <br /> Signature Registered Y/ N 1 Fee Current 1 Y/ N I <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 (httpilappraiser.pascogov.com) <br />