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;13-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit <br /> �., . ,.. _. .,.- :?ax�, .,�s-.. _, , a- �- -n�-s•. .taaav^�.�.w+. ..,. , _ <br /> Owner's Name IiA.! o�✓te f Owners Phone Number � 3 7(�� ��� ,S <br /> Owner'sAddress .5 �v /�-� �L l/�� � ,, , S' L� <br /> Fee Simple Titleholder Name Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> B�. '#'a; - s��?" , .:�R.�vfig:-- <br /> Job Address Lot # � <br /> Sub Division Parcel # <br /> :�..�,, �u�A,=�,r,. . �. - � <br /> a Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � lP/Natural 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 Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ L� ❑� � Sprinkler System Installations <br /> r� <br /> Hood Suppression � ❑ � ❑ � � Standpipes (Sprinkler Sys) <br /> � 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 /> ► :�x«,,:� ._..�,�.,.:��,.w;4��;.� :���z,. ��� ���,�.�-���.;� <br /> ,� :;z.P.;�.� . �:s�.�;���.����;.�� . � ;�� ��� , <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature Registered Y 1 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 /it �/'C � f/1 L <br /> Signature Registered N Fee Current / N <br /> Address License # �j'JG� � <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 (Mecha�ical 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 />