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813-780-0020 . City of Zephyrhilis Firms ' / 364 <br /> Fax - 813480 -0021 <br /> Permit Application <br /> )ate Receivelann Phone Contact for Permit <br /> )wner's Name C `/ a c 1- . L.` Owner's Phone Number I 5 N 9 ! I r <br /> U 6 3 <br /> )wner's Address ` r i 5 t F r' R. k 2.1 (' Allis F 1 3 3 S 4 .. <br /> =ee Simple Titleholder Name Titleholder Phone Number I f f I f <br /> : ee Simple Titleholder Address I <br /> Job Address I 2- e- y`- l y �- P :-% r Np t) N r LL C- Spy13r�CA -^ 3 _.,... I s M ME <br /> Sub Division N l • • `e.- 1 <br /> Parcel # 1 a, — ail) 'It Uv U a n �1 b G "�!� <br /> Blo-Hazard Waste Storage - ANNUAL Fumigation Tent <br /> ED Comm Exhaust Kitchen Hood/Duct El Hazardous Material (Tier liar RQ Facility) ANNUAL <br /> n Controlled Burn Hood Installation <br /> Emergency Generator < 30 kw r 1 LP /Natural Gas - Installation <br /> Emergency Generator> 30 kw LP /Natural Gas - ANNUAL Sale <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly- ANNUAL <br /> (:; jFll mr ED <br /> Sprinkler 1::] ❑ ❑ ❑ El Recreational Bum <br /> • <br /> Fire Alarm ❑ ❑ I ED Sparklers . <br /> Hood Cleaning ❑ ❑ I Sprinkler System Installations . 7 /Q+1e1�� id D <br /> Hood Suppression ❑ ❑ 0 Standpipes (Sprinkler Sys) 6J ~� hi 41'11- n Fire Alarm Installation ED Torah. Roofing/Tar Kettle L <br /> Fire Pumps I Waste Tire Storage ANNUAL Valuation of Project <br /> Fire Works • <br /> Flammable Application- ANNUAL <br /> Fuel Tanks <br /> Il Other. I <br /> Contractor <br /> ■ Signature } ' Company • r - .G ttt C <br /> 411 Registered KOMI Fee Current IM�( <br /> Address 3 f _ - <br /> ELECTRICIAN License* I E F opt!, '04 t I <br /> Signature ( Company <br /> Registered Y / N Fee Current Y / N <br /> Address I <br /> License # <br /> PLUMBER I <br /> Signature I Company <br /> Address I <br /> Registered Y / N Fee Curr <br /> License # I <br /> MECHANICAL! <br /> Signature l l j Company <br /> Registered YIN j Fee Current I Y/ N 1 <br /> Address I I I <br /> License # <br /> OTHER 111 <br /> Signature Company <br /> Registered Y / N Fee Curr Y / N <br /> Address <br /> Directions: �...— _..._ <br /> License # <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) <br /> If over 32500, a Notice of Commencement Is required (Mechanical work over 35000) <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 />