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, sis-; ao-oo2o City of.Zephyrhiils Fire Fax-813780-0021 <br /> �Permit Application <br /> Date Received Phon <br /> .;;�s�;:.....,�,.�.�s-�:�:;;:;.�,.� ,,_..�....�.......z.....�....»..� x.�..�.x e Contact for Pertnit ..._...,�.,,...��, .��,� <br /> Owner's Name � ��e Owners Phone Number ��� � � ? �'-�_ <br /> Owner's Address S 3 (',�GL �L (�` �� l��t l/S /�c- <br /> Fee Simple Titieholder Name TiUeholder Phone Number �� �� � <br /> Fee SimpleTitteholder Address <br /> M�e. .a �s,�� ' ; "�. .a�*�3�' a,wY <br /> Job Address � <br /> Lot # <br /> Sub Division Parcel # <br /> �.� <br /> � Bio-Hazard Waste Storage -ANNUAL � Fumigation?ent <br /> � Comm F�chaust Kitchen Hood/Duct � Hazardous Material (Tier il or RQ Facility) ANNUAL <br /> � Controlled 8um � Hood Instaliation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> � emi � er <br /> Sprinkler � ❑ ❑ ❑ � � Recreationai Bum <br /> Fire Alartn � ❑ ❑ ❑ � � 5parklers <br /> Hood Cleaning ❑ J,8( ❑� � Sprinkler System Installations <br /> Hood Suppression ❑ � ❑ � � Standpipes (5prinkler Sys) <br /> � Fire Aiartn Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> �; <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature I Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICA Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER Company Cv N /' <br /> w� r+►c°.�/ <br /> Signature Registered N Fee Current / N <br /> Address License # � � <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, noWrized (Or, copy of signed contract with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical work over $5000) <br /> Supply 1wo (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 />