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sisaeo-oo20 . • City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received � � GGl� Phone Contact for Permit �� � y� .S .�y � <br /> L...4..w,L=..��.1 <br /> Owner's Name (j�V� �� ( �,�,a� Owner's Phone Number � � � <br /> Owner's Address Gl,( b 0� GI.,S.s�t �`� ��J�.�. �_ �� <br /> Fee Simple Tit�eholder Name � Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> Job Address ^ � �,�, ` v Lot # � <br /> Sub Diwsion Parcel # �„�j — ��p � I — v� ` Q' �f�l[J�d ` <br /> � B o-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � C�mm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � C�ntrolled Burn � Hood Installation <br /> � Emergency Generator < 30 kw � LPlNatural Gas-Installation �� � �j�( <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale �\ <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL ��' � <br /> try emi �n t er � �� U <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Burn <br /> F.� i��c�i�'1 � ❑ ❑ ❑ � � Sparklers 1 /�3 / <br /> �/� <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> ssion � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> Fire Alar Installatio� � Torch Roofing/Tar Kettle <br /> � Fire Pumps_�._�-�" � Waste Tire Storage ANNUAL <br /> F�re Works <br /> � Flammable Application- ANNUAL r�Q ��(X:7 , Valuation of Project <br /> � Fuel Tanks <br /> � Qther• <br /> Contractor Company j + <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address VyHe � 17p ��cense # G G� <br /> ELECTRICIAN Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address <br /> 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 (http://appraiser.pascogov.com) <br />