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813-780-002D City of Zephyrhiits Fire <br /> Permit Application Fax-813-780-0021 <br /> Date Received �' �'�� ` <br /> _ Phone Contact for Permd �,?'} t' L.' z � q Q 3 <br /> Owner's Name � 4 � — I G � �� � or � (� <br /> Owner's Phone Number � 3 f � 1� / 3 � <br /> Ownar'sAddress � Z� i L_..L!8J <br /> � <br /> Fee S�mple T�tleholder Name � <br /> Fee Simple Trtleholder Address Titleholder Phone Number � L--- J <br /> JobAddress 3 2� ZZ� - - - _ -� � - - <br /> � � � � <br /> Sub Division Lot # <br /> _ , _ , Parcel # � <br /> � Bio-Fiazard Waste Storage - ANNUAL � - <br /> � Hazardous Material (Tier 11 or RQ Facilityl ANNUAL <br /> Comm Exhaust Kitchen Hood/DuCt � <br /> ❑ Hood Instaliation � <br /> Controlied Burn Q � <br /> ❑ LP/Natural Gas-Instaliation <br /> Emergency Generator < 30 kw Q � � <br /> ❑ LPlNatural Gas-ANNUAL Sale 1 � <br /> Emetgency Generator> 3G kw � j., <br /> �j � P�d��°c7fASS�mbly-ANVUAL <br /> , , Fire 'rocection Maintenance -ANNUAL �' <br /> try em � ef Recreational Burn \, <br /> Sprinkler a 0 '� ji � <br /> ❑ � � � Sparklers i i <br /> FireAlarm � � � � ❑ / i �� � <br /> ❑ Sprmkler System Installations � „r � � I /� <br /> Hood Cleaning n � � � ❑ �/A�% <br /> Standpipes (Sprinkler Sys) ri � P � <br /> Hood Suppression � p � � ('�_'� ❑ / � <br /> � U Torch Roofing/Tar Kettle —' – <br /> Fire Alarm Instaltation � -'� � <br /> � Waste Tire Storage ANNUAI <br /> Fire Pumps � <br /> � Fire Works <br /> � Flammable Application- qNNUAL <br /> � Fuel Tanks Valuation <br /> � Other ,' �i J <br /> Contractor �� <br /> Signature Company –f-- � � <br /> Registered Y/ N Fee Current Y/ N h <br /> Aadress 3g31 {�1C }on , <br /> License # Q s� g �� !.�, <br /> r�ECTRICIAN Z ` ^���� <br /> S�gnature Company f � � <br /> Registered Y/ N Fee Current Y/ N <br /> Address � <br /> PLUMBER ��cense # � <br /> S�gnawre Company <br /> Add!ess <br /> Registered Y/ N Fee Current Y/ N <br /> MECHANICAL License # <br /> S�gnawre Company r <br /> Address <br /> Registered �L Y/ �j � Fee Current Y/ N --� <br /> uTHER � <br /> License # �—` <br /> S�gr,a:ura � Company <br /> Add ress Registered Y/ N Fee Current Y/ N <br /> Cr,ecbons. - -- _ � _ Licenseit �-- <br /> F��� out application Completely <br /> Owner & Contractor sign back of application, notarized (Or, copy of signetl contract with owner) <br /> If over $2500, a NotiCe of Commencement is required (Mechanical work over $5000) <br /> Supply twp (2� sets of drawings with applicable documentation <br /> Allow 10-14 days for review aRer submittal date. Parcel #- obtained from Property Tax Notice Ihttp://appraiser.pascogov com) <br />