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a��-�ao-oo2o City of Zephyrhiils Fire <br /> Fax-813-780-0021 <br /> r Permit Application <br /> � Received i_?�-�� -' �—� Phone Contact for Permit �� �� ��I <br /> �ers Name S� /�L� S� ��/� � � J <br /> Owners Phone Number ?l /.� ��3 G d� b <br /> iers Address 5/(} G�9 e� /� [✓� Z��H �� �-/L'Z L f <br /> `( 3 3s��z <br /> Simple Titleholder Name Titleholder Phone Number ��� <br /> SimpleTitleholderAddress L� �.J <br /> Address ��f � G A t L <br /> c�� 2 E�°f/Y rtlz �I �� � 3 r L � <br /> Lot # <br /> Division <br /> Pareel # <br /> � Bio-Hazard Waste Storage - ANNUAL � <br /> � Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) qNNUAL <br /> � Controlled Bum Hood InstallaUon <br /> � Emergency Generator < 30 kw � <br /> a LP/Natural Gas-Installation <br /> Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sa1e <br /> � Fire Protection Maintenance -ANNUAL � <br /> Places of Assembly-ANNUAL <br /> L1_1 � em � � er � <br /> Sprinkler ❑ ❑ Recreational Bum <br /> Fire Alarm � � � � <br /> ❑ � � Sparklers <br /> Hood Cleaning p � � � <br /> ❑ Sprinkier System Installations <br /> Hood Suppression ❑ � � � ❑ <br /> � Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation � Toroh RoofinglTar Kettle <br /> � � Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> a Flammable Application- ANNUAL <br /> � Fuel Tanks Valuation of Project <br /> Q Other. <br /> tractor <br /> ature Company <br /> Address <br /> Registered Y/ N Fee Current Y/ N <br /> �TRICIAN <br /> License # <br /> ature Company <br /> Address <br /> Registered Y/ N Fee Cument Y/ N <br /> �ABER <br /> License # �-- <br /> �ture Company <br /> Address Registered Y/ N Fee Current Y/ N <br /> iANICAL <br /> License # <br /> ture Company <br /> Address Registered Y/ N Fee Current Y/ N <br /> :R <br /> License # �— <br /> �ure Company <br /> \ddress Registered Y/ N Fee Current Y/ N <br /> ons: <br /> Lice�se # <br /> Fill out application completely. <br /> Ovmer & Contractor sig� back of application, notarized (Or, copy of signed contrect with ownerj <br /> If over $2500, a Notice of Commencement is required (Mechanical work 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 h //a raiser.pascogov.com) <br /> � ttP� PP <br />