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a��-�so-oo2o City of Zephyri�ilis Fire Fax-813-780-0021 <br /> , Permit Application <br /> Date Received �_ y Phone Contact for Pertnit y � �� <br /> e. . ,.3.- ..,... . <br /> Ovmer's Name Owner's Phone Number /� D� � <br /> Owners Address �7 � G <br /> Fee Simple Titleholder Name G�/J /'/il L� Titleholder Phone Number �� � <br /> Fee Simple Titleholder Address <br /> � ,. ,:?'s ..yewr:.�: .rk�;�:'�s:�a;�3.a.�°.,�s*w�- . ,.- . ..�.. .>Q�4r�:�.�;x��.�'i-§st.�.k�. �a3"�ia45':a.ae�':�:� •�'9'«.>:� .. , �.. <br /> Job Address Lot # � <br /> Sub Division Parcel # <br /> . ,. ., ,,, ,. ...r' ".� ?'3<i�•3:...; ;:ow:: �;3 �f,s -� e � ;:s . - ,. , .� . ., n � ... >.. .'.am,'r+.,n.".a8'��`o-�5'�r:�.��d?tP�4%;•t;. .. .. , i:#A.«.: s : .� F .. a ., .. . .- t <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 � 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 e i n er <br /> Sprinkler � ❑ � Recreational Bum <br /> Fire Alartn � � � � Sparklers <br /> Hood Cleaning ❑ ❑ ❑� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes (Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofing/Tar Kettle <br /> a Fire Pumps � Waste Tire Storege ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL �_� Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> s „ � ... , �. .. , .r .. ?^,A:�. � , a.. ....: . .e , 3 . . ._ � , i . �c�;'.sFw:��n.�i;�..Ye�'' aT..r.:X': :.-eF;::»... `.=�;��; .. �.. « ., <br /> Contractor Company <br /> Signature Registered Y/ N Fee Current Y/ N <br /> Addres 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 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: " e . .�... _. % . , ,. , . . ... _..,.. , , < < <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 wo�lc 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 />