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s��-7ao-oo2o City of Zephyfiills�Fir� Fax-813-780-0021 <br /> Permit Application <br /> )ate Received - Phona Contact for Pertnit <br /> ;�w�a:.� �.,,:...... R.....,.,..�,..,.,�.�.:�,�.,.,..W.�..�„.,,�� <br /> )wners Name Owne�s Phone Number �� �� [�� <br /> �wners Address 3 � <br /> =ee Simple TiUeholder Name Titleholder Phone Number � C <br /> =ee SimpleTdleholderAddress <br /> Job Address � Gc. -�� Lat # C <br /> Sub Division � � .� Parcel # .. (� U ' Of) '(X�,Sv <br /> . �����+�. <br /> � Blo-Hazard Waste 5iocage - ANNIlAL � FumigaUon Tent <br /> � Comm Exhaust Iatchen HoodlDuct � Hazardous Mats�lal ('fler li or RQ Facility} ANNUAL <br /> � ConVo{led Bum a Hood Instatlatlon <br /> � Emargency Genertor < 30 kw � LP/Natural Gas-Installadon <br /> Emergency Generato�> 30 kw � LPMaGUaI Gas-ANNUAL Sale <br /> Flre Protectlon MaiMenance - ANNUAL � Places of Assembly-ANNUAt � ^ <br /> �y em� � ar (A <br /> Sprinkler �❑ O ❑� a Recreatlonal Bum j� ` � <br /> Rre Alartn O ❑ � � � Sparklers <br /> Hood Cleaning ❑ ❑ ❑� a Sprinkter System installations <br /> Hood Supptession �❑ ❑ O� � Standpipas (SprinWer Sys) <br /> Q Fire Alarm Installa8on � Torch. Roofing/Tar Kettle <br /> Fire Pumps � Waate llre 5torage ANNUAL <br /> Fire Wotks � <br /> Flammable ApplicaUon-ANNUAL r Valuation of Project <br /> Fuei Tanks <br /> Q Other: <br /> ConVactor c �.�_ � <br /> Compsrry � � = � ru�n�G' � . �. <br /> Signatura ' Registereil Y N Fee Current N <br /> Addross 1 � L'ICense # b� 1�'j <br /> ELECTRtC1AN <br /> Comparry <br /> Signatura ftegtstered Y/ N Fes Current Y 1 t�i — <br /> Address License # <br /> PLUMBER ' <br /> Company <br /> Signature Reglstered Y/ N Fae Curtent Y/ N <br /> Address <br /> License # <br /> MECHANiCAL <br /> Company <br /> Signature Registered Y/ N Fee Curtent Y/ NT —w <br /> Address <br /> License # <br /> OTHER Company <br /> 5lgnature Registered Y/ N Fee Current Y/ N <br /> Address Lic # <br /> Directions: --i '� 3 � ° ""� ` '--- � <br /> � <br /> FII aut applfca0o� completely. <br /> Owner 8 Contraetor sign bacic of applicatior�, notarized (Or, copy of slgned contract with owner) <br /> If bver 5250D, a Notice of Commencement is required (Mechanipl work over 35000) <br /> Supply two (2) sets of drawings with epplicsble dacumerdation � <br /> Aliow 10-14 days for revfew after suhmittal date. Parcel #- obtained frora Property Tax NoBcs (http:/lappraiser.pascogov.00m) <br />