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si�-��p-oo2o City of Zephyrhilis Fire <br /> Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> r�-.�.���w: �4:.���.>.4-,����„ �w�.���:,� 1' 0 1 3I <br /> �; . �.�.�. <br /> Owner's Name '�e s�y Owner's Phone tJumber � t /S�'? I J� � <br /> L'.,SG.ZJ <br /> Owners Address <br /> Fee Simple Titleholder Name TiUehplder Phone Number �� �� <br /> Fee Simple TiUeholder Address J�--�.�.�J <br /> �,�<aa�: ;°� <br /> ' � ; � � <br /> Job Address � I u �� <br /> � Lot # <br /> Sub Division <br /> , , �, r � w ;. Parcel # <br /> ,.. n..,.�,,,z. ^ .;'h;�5'ds&x� - k;�!�}+'"'rs=t; - urcta�:�.«.� ���sfi,'�:`:Yex£.��s.,xa�.:%w.'_'w'-„' '. . <br /> � '�r'�[iv`..�.�.$"'n��;i�Y.�!g. �. ...13"'@i:;." +^=BWSd.'�1YS.���,',.',�`" n�=e:�„���:; . <br /> � � ���v ., ". ��Ft�' ', ?�_a",a5i, <br /> Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material (Tier il or RQ Facility) ANNUAL <br /> � Controlled Bum a Hood Instailation <br /> � Emergency Generator < 30 kw � LP/Naturat Gas-tnstallation <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sate <br /> Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> ❑ � emi � er � <br /> Sprinkler ❑ ❑ O � Recreational Bum G� <br /> Fire Alarm � ❑ ❑ ❑ � Sparklers :`�, 1 l � � ✓ <br /> Hood Clea�ing � ❑ ❑ ❑ T <br /> � � Sprinkler System Installations ' <br /> Hood Suppression ❑ ❑ ❑ � Standpipes {Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofingfTar Kettfe <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable Application- ANNUAL <br /> � �� Valua6on of Project <br /> Fuel Tanks <br /> Q Other: <br /> � . �:�� H�t:��.�w��� � <br /> Cornractor �'" � - <br /> ti��a�at <br /> Signature Company � n <br /> R89istered Y N Fee Current N <br /> Address /n 0. <br /> 3�a ' License # <br /> ELECTRIClAN <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER <br /> Signature Company <br /> Reyistered Y! N Fee currern Y/ N <br /> Address <br /> License # <br /> MECHANICAL <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address � <br /> License # <br /> OtHER <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> a '�: �.�;�..�,,,...:. -,.�y-_ , „ -t. . . _ . <br /> License # <br /> Directions: . .. . . . , � . . �_ £. , , .,.� .��� �; �.���< . <br /> Fill out application completely p �� r* �,{,� Y ��� ��� y � <br /> Owner & Contracto� sign back of appticatlon, notarized (pr, cppy of signetl contract uvith ovmer) <br /> If over $2500, a Notice of Commencemerrt is required (Mechanical woric over $5000) <br /> Supply iwo (2) sets of drawings with appliqble documentation <br /> Ailow 10-14 days for review after gubmittal date. Parcel #- obtained from Pro <br /> peAy Tax Notice (http://appraiser.pascogov.com) <br />