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eiaaao-oo2o City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received � Phone Contad for Pertnit �� � <br /> Owner's Name � 1 r� l'� ) � �S / � /�U� }l � ��(' Owners Phone Number [SLLS�L_J / a �. � � � <br /> Owner's AdZ7ress ' � c1 �O � !"� lN . `�' �-= � Z L- I'" 1 � Y R�� !�- L- � 0�' L. �� �J �' 2..� <br /> Fee Simple TiUeholder Name Tdleholder Phone Number �� � <br /> Fee Simple Titleholder Add�ess <br /> , , . , ,. , <br /> Job Address � � (s� � 2-i-. � `� ��,. �.:.� � �� : . �:,. .: ,.;r _�... �.... ._...,. . . . .,. � . . _;...._ ,. . - <br /> , . .� . �:;..,.. � . . .......... .. . , . <br /> s z�.=n��2N���s L..�,� a- �ot# 0 <br /> SubDivision Parcel# ��-.z��� <br /> � Bio-Hazard Waste Storage - ANNUAL � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Comm Exhaust IGtchen Hood/Duct � Hood Installation <br /> a Controlled Burn � LP/Natural Gas-Installation <br /> a Emergency Generator < 30 kw a LP/Natural Gas-ANNUAL Sale <br /> � Emergency Generator > 30 kw �Places of Assembly-ANNUAL <br /> � Fire Protection Maintenance - ANNUAL � Recreational Bum <br /> � mi � er <br /> Sprinkler � ❑ ❑ ❑ � SparkleB <br /> Fire Alartn � ❑ O ❑� � Sprinkler System Installations <br /> Hood Cleaning � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> Hood Suppression � ❑ ❑ ❑� � Torch Roofing/Tar Kettle <br /> � Fire Alarm Installation � Waste Tire Storage ANNUAL <br /> a Fire Pumps <br /> � Fire Works <br /> � Flammable Applicatio�- ANNUAL r Valuation of Project <br /> � Fuel Ta�ks <br /> Q Other: <br /> , , . ,..,,•. .. . ,:. . _r. - - <br /> ,- . , ..; .. ..:..,,:�...,:...: ,, . _ <br /> ._, : :..�...,; �, <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 Currern Y/ N <br /> Address License # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address �icense # <br /> OTHER Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> _ _ , _ .. _. - � ._. <br /> Directions: <br /> FiII out application completely. <br /> Owner & Contractor sign back of application, noharized (Or, copy of signed contrad with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanipl work over $5000) <br /> Supply rivo (2) sets of drawings wffh applicable documentaUon <br /> Allow 10.14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraise�.pascogov.com) <br />