Laserfiche WebLink
si saao-�o2o City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> . �— <br />)ate Received � " Phone Contact for Pertnit <br /> w�,w�eu.,e�,�,e.�.. ,;a.tM, _ �� aN.+mK 7m <br /> Avner's Name � �,>TU��S �-E'G�Y�� C.Qj�T2 t�- Owners Phone Number $(3 7�p Q g y � <br /> hwner's Address ���j� l p}� S��Q-e 1 <br /> ee Simple Titleholder Name �,�� b ( y-� Titleholder Phone Number � � � <br />�ee Simple Titleholder Address <br /> Fr.�_.r:,°���:.:�^� <br /> iob Address Lot# � <br /> iub Division Parcel# <br />� .�•4 _ .� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)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 , �e ,. r ( <br /> j ,•..: <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL r.. ' , " <br /> �y emi �n er �' ( <br /> Sprinkler ❑ ❑ O � � Recreational Bum <br /> Fire Alarm g O ❑ �' � Sparklers <br /> � <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar 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 />_.,.�:���.�:�.� ,� . � <br />;ontractor n , �^ � +Q nL, ,� Company C.�r-.� <br /> U 1_,a_ M1� � �� �ti Gi�''vv� S+-2v�-�S <br /> iignature ��,yr��`6.�u� d'CS �✓�-+��C� <br /> Registered Y/N Fee Current Y/ <br /> Address License# <br />=LECTRICIAN Company <br /> iignature Registered Y/N Fee Current Y/N <br /> Address License# <br />'LUMBER <br /> Company <br /> iignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> AECHANICAL Company <br /> iignature Registered Y/N Fee Current Y/N <br /> Address License# <br />)THER <br /> Company <br /> tignature Registered Y/N Fee Curre�t Y/N <br /> Address License# <br />)irections: <br /> Fill out application completely <br /> Owner 8 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:/lappraiser.pascogov.com) <br />