Laserfiche WebLink
,e�,r-�so-oo2o City of.Zephyrhilis Fire Fax-813780-0021 <br /> Perrnit Application <br /> Date Received 2�, Phone Contact for Pertnit ��������� <br /> Owner's Name �1.1..5 1 Owners Phone Number �� �•� <br /> Owners Address ��'� I Q Cp 1 N�(.' � Z� �1— <br /> Fee Simple Titleholder Name TiUeholder Phone Number �� C <br /> Fee SimpleTitleholder Address <br /> .� <br /> Job Address Lot # C <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storage -ANNUAL a Fumigation?ent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-fnstallation <br /> � Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL 5ale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> �y emi � er � �� Z <br /> Sprinkler � ❑ ❑ �, � Recreational Bum 1 <br /> Fire Alartn � ❑ ❑ � � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� a Sprinkler System tnstallations <br /> Hood Suppression � O ❑ ❑� � Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh RoofinglTar Kettle <br /> � Fire Pumps a Waste Tire Storege ANNUAL <br /> � Fire Works <br /> Flammable Application- ANNUAL � Valuation of Project <br /> � Fuel Tanks <br /> Q Other. <br /> Contractor Company <br /> Signature Registered / N Fee Current Y/ N <br /> Address � �y � License # <br /> ELECTRICIAN Company <br /> Signature � Registered Y/ N Fee Curtent 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 <br /> Signature Registered Y/ N Fee Current Y! N <br /> Address License # <br /> Directions: <br /> Fill out application completely. <br /> Owner & ConVactor 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 1wo (2) sets of drawings with applicable documentation <br /> Allow 'I D-14 days for review after submittal date. Parcel #- obtained irom Property Tax Notice (httpJlappraiser.pascogov.com) <br />