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a�3-�so-oo2o City of Zepi��yrhi;is Fire Fa;-813-780-0021 <br /> Permit Application <br /> Date Received � �/� Phone Contact for Permit y� �rsd o ,3� <br /> Owner's Name LL�CINA S s `� ��/7+�° /�� �C'C Owner's Phone Number ��� <br /> Owner's Address ? , J'A� � �� k �n ! �'• 3 ' 3 ��`� <br /> Fee Simple Titleholder Name Titleholder Phone Number ��� <br /> Fee Simple Titleholder Address <br /> Job Address Lot # � <br /> Sub Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier il or RQ Facility) ANNUAL <br /> � Controlled Burn � 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 /> tr y emi �n t er /� <br /> Sprinkler � ❑ � � � Recreational Burn � I <br /> Fire Alarm � ❑ ❑ � Sparklers <br /> Hood Cleaning � ❑ ❑ �� � Sprinkler System Installations <br /> Hood Suppression � ❑ � � � � Standpipes (Sprinkler Sys) <br /> a Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application- ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> � Other� <br /> Contractor Company � 1t � j/�/�� <br /> Signature Registered Y/ Fee Current Y! N <br /> Address License # <br /> ELECTRICIAN Company <br /> Signature I 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 <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 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 />