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813-780-OQ20 City of ZephyrhiUs Fire Fau-813-780-0021 <br /> Permit Application <br /> 3te Receiver;,. �e��� r"''�'—� �� � <br /> , Phone Contact for Pertnit L_vJ _J O ZS <br /> wner's Name � `� z.L ) ` (+ � <br /> � Owners Phone Number �'���j gp� �� - <br /> wner's Address ,,J��-� �y� i'�✓ !-���J F !' /7', ',� � - �Z����� <br /> y <br /> �e Simple Titleholder Name Titleholder Phone Number C� C� � . <br /> �e Simple Titleholder Address <br /> �b Address � �G r h/ ��'S ,�� �� v 3 a �� <br /> �ot# �� <br /> �b Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL a Hazardous Material(Tier 11 or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen Hood/Duct a Hood Instailation <br /> � Controlled Bum � LP/Natural Gas-Installation <br /> � Emergency Generator<30 kw � ��� � LP/Natural Gas-ANNUAL Sale <br /> � Emerge�cy Generator>30 kw � � Places of Assembly-ANNUAL <br /> � Fire Protection Maintenance-ANNUAL � � <br /> Recrealional Bum <br /> rTy emi � er ❑ <br /> �7V'CC.IV����V Sprinkiei � ❑ ❑ Ci Sparklers ���" <br /> � 7 <br /> �� �/�J! Fire Alarm � ❑ ❑ ❑ � � Sprinkler System Installations � <br /> � r <br /> � n � Hood Cleaning � ❑ ❑ ❑ �� � Standpipes(Sprinkler Sys) <br /> `T Hood Suppression � �,� ❑ ❑ C� � Toroh Roofinglfar KeNle <br /> � Fire Alartn installation � Waste Tire Storage ANNUAL <br /> � Fire Pumps <br /> � Fire Works <br /> � Ftammable Application-ANNUAL r Valuation of Project <br /> � Fuel Tanks <br /> � � Other: <br /> �ntractor � Com an <br /> J�J /% .f — a y <br /> � � R �a <br /> gnature L V � ,L � — <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> Lice�se# <br /> _ECTRICtAN 7t `I � , <br /> gnature � .''/ �� � �f� ' � ,�_� � �2�_ o�npany <br /> y'nS� V'L�egistered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> _UMBER <br /> Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ECHANICAL I 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 /> 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 /> 5upply 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 /> ��.��� � . <br /> `� <br />