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s� �-�ao-ao2o City of Zephyrhiils'Fir� Fax <br /> , Permit Application � <br /> )ate Received - Phone Contact for Permit �/��.�� <br /> i�`-�'&':S.sZ§z.Rr�;�FiG�Ii'��:asuw�:.w+.a� a.w.r _ _.. <br /> ,_. .L.L�� ` _ <br /> huner's Name Owne�s Phone Number <br /> �wners Address e �, �� (� <br /> =ee Simple TiUeholder Name Titlehol er Phone Number ��� <br /> =ee Simple Titleholder Address <br /> �++,. . �.�ls'�+:�i..'�'�� <br /> Job Address Lot # � <br /> Sub Division � j�' e 1 Parcel # �p� ��! •�V �� <br /> �sa:�a�-- , .�. , s-aes� <br /> � BfaHazard Waste Storage - ANNU L � Fumiga8on Tent <br /> � Cornm Exhaust Kltchen HoodlDuct a Hazardous Material (7'ler li or RQ Facillty} ANNUAL <br /> � ConVolled Bum � Hood {nstallaUon <br /> � Emergency Generator < 30 kw a LP/Naturaf Gas-Instaliation <br /> Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale <br /> Fire Protection Mairttenance -ANNUAL a Places of Assembly-ANNUAL <br /> r y emi � ar <br /> 5prinkler �❑ O O� a Recreadonal Bum <br /> Fre Alarm � p p��� � Sparklers <br /> Hood Clsaning O O ❑� a Sprinkler System installatlons <br /> Hoad Suppresslon �❑ 0 O� � Standpipes (Sp�nWer Sys) <br /> � Fire Alartn Installation � Torcfi. RaofinglTar FCettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> Flammable ApplicaUon-ANNUAL Vafuation of Project <br /> Fue( Tanks <br /> Q Other; <br /> � <br /> ConVa�tor J / Comparry � • �.+G ;it'itvh�' L, <br /> Signature 1�•- ' Registerad Y V N Fee Curcent N�� <br /> Addross 1 � License # �j b �� <br /> ELECTRICIAN Company <br /> 5ignature Registered Y! N Fee Curtent Y/ N <br /> Address Lfcense i� <br /> PLUMBER Company <br /> Signature RBgistBred 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 <br /> 5ignature Registered Y/ N Fee Current �/ N <br /> Address <br /> Lioense # <br /> – - �.,.�x� <br /> ----�------ -��.u,�,o .�.�� - --� .�..�..�..�,a�am ._. ._. _., _—___..,.... ._„,�....3F,.,_..__,. <br /> �irections: <br /> Fill aut application complstely. <br /> Owner 8 Contractor sign back of appiicatior�, notarized (Or, �opy of signed wntract with owner} <br /> If over $250D, a Notice af Commencement fs requlred (Mechaniea! work over 35000) <br /> Supply two (2) sets of drewings with applicabie dacumerrtatlon � <br /> Allow 10-14 days for rev[ew after submitta! date. Parcet #- obtained frora Property Tax NoUce (http:/lappraiser.pascogov.com) <br />