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a�3-�so-oo2o City of Zephyrhilis Fire <br /> Permit Application Fax-813-780-0021 <br /> Date Received ' � Zp�� <br /> Phone Contact for Permit C -== � _ J lasQ <br /> owner's Name ��n��,(,4. �1�/ ,� L B � 3S <br /> Z� h "%�� Owner's Phone Number ��� � <br /> Owner's Address 7� GA� /JL � z /� Rh� �S ��, 33S'//� <br /> T <br /> Fee Simple Titleholder Name � �� �� <br /> Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> Job Address �� <br /> Sub Division Lot # <br /> Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � <br /> � Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Burn � <br /> � Hood Installation <br /> Emergency Generator < 30 kw � <br /> � LP/Natural Gas-Installation <br /> Emergency Generator > 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � % � �7 � / / <br /> Places of Assembly-ANNUAL � /5 `� <br /> tr y emi � t er ❑ J <br /> Sprinkler � � � <br /> � Recreational Burn <br /> Fire Alarm � � � �I ❑ <br /> ❑ L_J Sparklers <br /> Hood Cleaning � � � � ❑ <br /> ❑ Sprinkler System Installations <br /> Hood Suppression ❑ � � ❑ <br /> � Standpipes (Sprinkler Sys) <br /> Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � <br /> ❑ Waste Tire Storage ANNUAL <br /> Fire Works <br /> � Flammable Application- ANNUAL <br /> � Valuation of Project <br /> Fuel Tanks <br /> 0 Other <br /> Contractor <br /> Signature ` /' Company �� . ��� <br /> Registered Y/ Fee Current Y/ N <br /> Address <br /> ELECTRICiAN License # <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> PLUMBER <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> MECHANICAL <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # � <br /> OTHER <br /> Signature Company <br /> Registered Y/ N Fee Current Y/ N <br /> Address <br /> Directions License # <br /> Fill out application completely <br /> Owner & Contractor sign back of applicahon, 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 drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date Parcel #- obtained from Property Tax Notice htt //a <br /> � p ppraiser.pascogov com) <br />