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:�3aao-oo2o City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received O// Phone Contact for Permit g 3 �� � l�� <br /> Owner's Name �i '� : 2 Zc�- Owner's Phone Number ��3 ��O � p/ <br /> Owner's Address � �,3� (1 �� Z � � �l 3 3S <br /> ! <br /> Fee Simple Titleholder Name Titleholder Phone Number �� C� � <br /> Fee Simple Titleholder Address <br /> , ,. ,�.,u ; - . . <br /> .. •: �:>.. , <br /> Job Address c( �Q� Lot # C� <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum a 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-ANN �� i� <br /> ❑ � emi �n er � 1 � � <br /> Sprinkler ❑ ❑ O Recreational Bum �� , <br /> Fire Alartn � ❑ ❑ ❑ �� � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression ,� ❑ �^ p �� ❑ <br /> /�. Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofinglfar Kettle <br /> a Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL <br /> Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> Contractor � " ' ` <br /> Company �'� ,• L <br /> Signature �l�t <br /> Registered Y/ N Fee Current Y/ N <br /> Address � o . (3ajC � <br /> � �� 6 3 License # <br /> ELECTRICIAN <br /> Company <br /> Signature I Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER <br /> Signature <br /> Compa�y <br /> Registered Y/ N Fee Cument Y/ N <br /> Address <br /> License # <br /> MECHANICAL <br /> Signature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> OTHER <br /> 5ignature <br /> Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address � <br /> License # <br /> �irections: ._,_, <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 (Mechanical work over $5000) <br /> Supply two (2) sets of drewings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice (http://appraiser.pascogov.com) <br />