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813-780-4020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> • Permit Application <br />)ate Received Phone Contact for Permit <br /> 6.,. > .��;.R, .�,-,��-n�.��x��.�� _, ..�._x- �.., .-�.-��, ,�,;�•�-..6 , . , � <br /> Nvner's Name � /C G' Owner's Phone Number � � � <br /> Tnmer's Address � Q�j ��l r � <br /> ee Simple Titleholder Name Titleholder Phone Number � � � <br />�ee Simple Titleholder Address <br />, ,.,*;:x° �..zr . �_ ��.��t:.. �� <br /> iob Address Lot# � <br /> iub Division Parcel# <br /> _.>�, - ., , „M.e�u. ,. ,-����,� <br /> aa�a�*', ��.=.� �^s r� . ��, <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> aControlled Bum � Hood Insfallation <br /> � Emergency Generator<30 kw � LP/Natural Gas-installation <br /> a Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ O ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ � � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation a Torch Roofinglfar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br /> F. .._�:. �_ _. ��t'����F P�i,�t- - -'fi�«�_�i !�; . _ . _ �7.�:'�vP��.+;;�"_ ., , _ <br />�ontractor Company e � �' <br /> 3ignature Registered Y/N Fee Current Y/N <br /> Address License# <br />=LECTRICIAN Company <br /> iignature Registered Y/N Fee Current Y/N <br /> Address License# <br />'LUMBER Company <br /> iignature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> dECHANICAL Company <br /> iignature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />)THER <br /> Company <br /> iignature Registered Y/N Fee Current Y/N <br /> Address License# <br />)irections: <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 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 />