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813-780-002Q City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received � � 2 � � Phone Contact for Pertnit �j 1� � - y yC�s� <br /> wner's Name � ) ' (.� Owner's Phone Number � � � <br /> wner's Address ��/ "! (TI� �� V Z h r � S �(.-. 3�j Z <br /> �e Simple Titleholder Name Titlehoider Phone Number ��� <br /> �e Simple Titleholder Address <br /> �b Address '� � J J � y � � G" 1�"� � � � � !'� �) � 3 S4 Z Lot # � <br /> ab Division Parcel # <br /> � Bio-Hazard Waste Storage - ANNUAL a Hazardous Material (Tler II or RQ Facility) ANNUAL <br /> � Comm F�chaust Kitchen Hood/Duct � Hood Installation <br /> � Controlled Bum � LP/Natura� Gas-Installation <br /> � Emergency Generator < 30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Emergency Generator > 30 kw � Places of Assembiy-ANNUAL <br /> � Fire Protection Maintenance - ANNUAL � Recreational Bum <br /> �y emi �n er ! r n 71 <br /> II.` � // v <br /> ��"' Sprinkler � ❑ ❑ ❑ � � Sparklers E v� <br /> � �l q/� � Fire Alarm � ❑ ❑ ❑� � Sprinkler System Installations <br /> � m id��+� Hood Cleaning ❑ ❑ ❑� � Standpipes (Sprinkler Sys) <br /> Hood Suppression � ❑ ❑� � Torch Roofing/Tar Kettle <br /> � Fire Alarm Installation � Waste Tire Storage ANNUAL <br /> Q Fire Pumps <br /> � Fire Works <br /> � Flammable Appiicatlon- ANNUAL r Vatuation of Project <br /> � Fuel Tanks <br /> Q Other <br /> mtractor � % �� � — � I �' L � Company <br /> (il. lr <br /> gnature Registered Y/ N Fee Curcent Y! N <br /> Y'��,�^""'°'S Z " � License # <br /> _ECTRICIAN Company <br /> gnature Registered Y/ N Fee Current Y/ N <br /> Address �icense # <br /> _UMBER Company <br /> gnature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> ECHANICAL Company <br /> gnature Registered Y/ N Fee Current Y/ N <br /> Address License # <br /> THER <br /> Company <br /> gnature Registered Y/ N Fee Current Y/ N <br /> Address <br /> License # <br /> �rections: <br /> Fiil 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 Properly Tax Notice (http://appraiser.pascogov.com) <br /> VIGIL INC <br /> HeOd � � C� Svc. <br /> 1 � P.�. N�o[ 273R? •'i�y Ff 33� <br /> � Q�,� 1 l�� � P: a13!l32��N F: �13�3-� <br /> gat�'a�e�►ayQael.can <br />