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a��-�so-oozo City of Zephyrt�ills Fire <br /> - Fax-813-780-0021 <br /> Permit Application <br /> : Received ;� �j / Phone Contact for Pertnit � �p s 1j73 S <br /> iers Name ,Z �� ' ,gL �� r� � Owner's Phone Number C� U � <br /> ier'sAddress � �(S �'Q/K �CD14�( � �' 1� � ��S" <br /> Simple Titleholder Name Titleholder Phone Number � C� � <br /> Simple Titleholder Address L�l <br /> Address � <br /> Lot # <br /> Division <br /> Paroel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigation Tent <br /> � Comm F�chaust 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/Naturel Gas-ANNUAL Sale <br /> � Fire Protection Maintenance - ANNUAL � Places of Assembly-ANNUAL <br /> _ [�' ' emi � er � <br /> Sprinkler �!�� {� <br /> U � � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ �� � Sparklers <br /> Hood Cleaning � p � � r� Q <br /> ❑ �� ❑ Sprinkier System Installations <br /> Hood Suppression ❑ ❑ ❑ Standpipes (Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Fiammable Application- ANNUAL <br /> � Fuel Tanks �� Valuation of Project <br /> Q Other: <br /> ractor <br /> ature � Company %�t �C i � � <br /> Registered Y N Fee Cument Y/ N <br /> Address <br /> License # � <br /> :TRICIAN <br /> iture Company <br /> Registered Y/ N Fee Cument Y/ N <br /> Address <br /> License # �— <br /> IBER <br /> ture Company <br /> 4ddress <br /> Registered Y/ N Fee Cument Y/ N <br /> License # <br /> IANICAL <br /> :u2 Company <br /> lddress Registered Y/ N Fee Current Y/ N <br /> R <br /> License # <br /> ure Company <br /> ,ddress <br /> Registered Y/ N Fee Current Y/ N <br /> �ns: <br /> Lice�se # � <br /> Fill out appiication completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contrect with owner) <br /> If over $2500, a Notice of Commencement is required (Mechanical work over $5000) <br /> Supply two (2) sets of drewings with appiicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel #- obtained from Property Tax Notice h //a <br /> � ttP: ppraiser.pascogov.com) <br />