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' ' s��-�aaoo2o City of Zephyrhilis Fire Fax-813-780-0021 <br /> . �. Permit Application <br /> Date Received �j �� '-_� Phone Corrtact for Permit �� � Q �J <br /> Owne�'s Name — Owners Phone Number �"_�� 'S Z- � C� "� <br /> Owners Address 5 j <br /> Fee Simple Titleholder Name TiUeholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> Job Address L Lot # � <br /> Sub Division Parcel # �0 I� Z� O Z/ <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Terrt <br /> � Comm Exhaust Kitchen FbodlDuct � Hazandous Material (Tier II or RQ Facility) ANNUAL <br /> � CoMralled Bum � Hood Installation <br /> � Emergency Generator < 3p kw � LP/Nalural Gas-InstaGation � J <br /> Q Errrergency Generator > 30 kw � LP/Natural Gas-ANNUAL S�e . ,� <br /> � Rre Protection Maintenance - ANNUAL � Places aF Assemby-ANNUAL <br /> � �� <br /> Sprinkler � ❑ ❑ O � � Recreational Bum , � / 9� 2 <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers � <br /> Hood Cleaning �❑ ❑ �� � Sprinkler System Installations _ <br /> Hood Suppr�sion � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> .�,_ <br /> � Fire Alarm InstallaGon � Torch Rooflng/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> n Fire works <br /> �� FlammableApplication-ANNUAL c� <br /> �J /� . a � Valuation of Project <br /> � Fuel Tanks <br /> Q Other. — <br /> ConUacfor Cotr�pany <br /> Si9nature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Sgnawre � Registered Y! N Fee Current Y/ N <br /> Address Licerwae # <br /> PLUMBER Company <br /> Signature Registared Y/ N Fee Current Y/ N <br /> Address Lice�e # <br /> MECHANICA Company <br /> signature Registered Y/ N Fee Current Y! N <br /> Address Licer►se # <br /> OTHER /d Company V �� � <br /> Signature � f���'�'C`�'�`` Registered N Fee curtent N <br /> Address / 3U P�V = License# ZOpv <br /> Directions: , . . .... � .. . . „ . . <br /> Fill out appiicadon compietely. <br /> Owner & CoMractor sign back of applicatlon, notarized (Or, copy of signed contract with ovmer) <br /> If over $2500, a Notice of Commancement is required (Mechanical work over 55000) <br /> Suppiy two (2) sets of drawings Wifh applicable documerrtation <br /> Allow 10-14 days for review aiter submittal date. Parcel #- obtained from Property Tax Notice (httpJlappraiser.pascogov.com) <br />