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81:, , City of Zephyrfiills Fife Fax-813-780-0021 <br /> Permit Application <br /> : Received '� � Phone Contact for Permit �_] �� <br /> iers Name S �1 � Owners Phone Number �� � <br /> ier's Address ��-`�/ �K �r ✓�G. ti <br /> Simple Titleholder Name Titleholder Phone Number ��� <br /> Simple TiGeholder Address <br /> Address Lot # � <br /> Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL � Fumigalion Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> � Controlled Bum � Hood Installatlon <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 /> ❑ � emi � er � <br /> 5prinkler ❑ ❑ ❑ Recreational Bum <br /> FireAlartn Q Sparklers � � Z � �� <br /> Hood Cleaning ❑ ❑ ❑� � S'rinkler System Installations <br /> Hood Suppression � ❑ D O� � 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 Valuation of Project <br /> � Fuel Tanks <br /> � Other. .i 74-L( Uh.� (.� — �,c /.4•�h C�� .t.�..,� st?os . � I'ho••..Te�tr�. <br /> tractor Company <br /> iacure Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> :CTRICIAN Company <br /> iature � Registered Y/ N Fee Curtent Y/ N <br /> Address License # <br /> IMBER Company <br /> iature Registered Y/ N Fee Cument Y/ N <br /> Address <br /> License # <br /> �HANICAL <br /> Company <br /> iature Registered Y/ N Fee Current Y/ N <br /> Address __ <br /> - License # <br /> 1ER � ' Company i¢ ��,,,� ,S" <br /> , Y/s +a <br /> iature - Registered N Fee Current Y/ N <br /> Address . Q b Q) � � t L License # �' GYXX) ,s <br /> ctions: <br /> Fill out application completely. <br /> Ovmer & Contractor sig� 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 />