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813 -780 -0020 City of ZephyrhillS Fire l / Z (6( Fax - 813- 780 -0021 Permit Application I Date Rec Aivet: . l / 2- - -I /0 I Phone Contact for Permit I 1 1 1 1 I Owner's Name I Cit/,4 L o-t - Owners Phone Number I 1 1 1 1 Owners Address I I Fee Simple Titleholder Name I Titleholder Phone Number I I I Fee Simple Titleholder Address I I Job Address - 7& 3) 6 /hi- L ii-a0 Lot # Sub Division Parcel # I I El Bio -Hazard Waste Storage - ANNUAL n Fumigation Tent n Comm Exhaust Kitchen Hood /Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL El Controlled Bum El Hood Installation Emergency Generator < 30 kw I LP /Natural Gas - Installation Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sale Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL JQtriyl Maj irrsll Other Sprinkler k ❑ ❑ n Recreational Bum Fire Alarm 0 ❑ ❑ ❑ I 1 n Sparklers Hood Cleaning E ❑ ❑ ❑ I 17 Sprinkler System Installations Hood Suppression n ❑ ❑ ❑ I ( = Standpipes (Sprinkler Sys) El Fire Alarm Installation n Torch Roofing/Tar Kettle n Fire Pumps n Waste Tire Storage ANNUAL ri Fire Works Flammable Application- ANNUAL 1 I Valuation of Project n Fuel Tanks Q Other: I I Contractor Company I Signature Registered Y/ N I Fee Current 1 Y/ N I Address I License # I I ELECTRICIAN Company I Signature I Registered Y / N _I Fee Current I Y/ N I Address I License # I I PLUMBER Company I Signature Registered Y / N J Fee Current I Y/ N I Address I ( License # I I MECHANICAL Company I Signature Registered Y/ N I Fee Current I Y/ N I Address I I License # I 1 OTHER Company I Signature Registered Y/ N I Fee Current 1 Y/ N 1 Address I I License # I I Directions: Fill out application completely. Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) If over $2500, a Notice of Commencement is required (Mechanical work over $5000) Supply two (2) sets of drawings with applicable documentation Allow 10 -14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com)