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813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Applicatiqn <br /> ate Received �' —L 7- ��- ����/�t�� S�� - ""n�ne Contact for Permit � � � <br /> r . ,. � ��`�r <br /> wner's Name � ��.f-"�`'''q� �E -� �'�'f �✓U��n� Ommers Phone Number � � � <br /> wners Address � 3v/ ,.S/^��"J �f Z��1��y/�t� /� 3,�� Z <br /> 3e Simple Titlehoider Name TiUeholder Phone Number � � � <br /> 3e Simple Titleholder Address <br />�b Address Lot# � <br />�b Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � FumigaUon Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Faciliry)ANNUAL <br /> � Controlled Bum � 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 Q Places of Assembly-ANNUAL �� <br /> �y� j� <br /> P ��y emi �� � �� <br /> S rinkler ❑ ❑ Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ O � � Standpipes(Sprinkler Sys) <br /> � Fire Alartn Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> aFire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other. <br /> mtractor Company �.C,tiA-��?J�..q( � '�t C� ���J/'�t/X� .� � <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br />_ECTRICIAN Company <br /> gnature � Registered Y/N Fee Current Y/N <br /> Address License# <br />_UMBER Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br />=CHANICA Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> fHER Company <br /> 3nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> rections: <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 NoUce of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable dxumentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />