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�;-�aao-oozo City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> �ate Received '" Phone Contact for Pertnit <br /> . . _ _ _ . �,�. �. � ,.,W... ,,.. _>. .,, . . .n. , �:�»,�,,, nre. �.� ,� t .._ , <br /> Jwner's Name � / / Owners Phone Number (�� 3 �� 7�n <br /> Jwner's Address �.30 �o,�7<i �� �� <br /> �ee Simple Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> , -. „ °.>. ��v�::� ., °� �`'`' ° ' <br /> Job Address Lot # � <br /> 5ub Division Paroel # <br /> e, . „� .�� �s� _ - _ _ . -.��:a,�F.3`��� �:o.�:.b:r - r�.*.��: - - - . ., .. <br /> � Bio-Hazard Waste Storage - ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum a Hood Installation <br /> a Emergency Generator < 30 kw � LPlNatural Gas-Installation <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alartn � ❑ O ❑ � � Sparklers <br /> Hood Cleaning � ❑ O @( � � Sprinkler System Installations <br /> Hood Suppressio� � ❑ � ❑ � � Standpipes (Sprinkler Sys) <br /> a Fire Alarm 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 /> ► , �:,��m�.. „.:�.�� � �. _�.��.� �:<r«�. �}.���.. K��9,��� �.�>....�, k ... �;��. :��,�:�.��-•��;� <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature 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 /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> OTHER Company �v� � j ,�+-� �.l�l,.�..a�,.•� r" r. ."_ <br /> Signature Registered / N Fee Current / N <br /> Address License # �0,�!' � <br /> F <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 />