Laserfiche WebLink
813-780-0020 Ciry of Zephyrhilis Fire <br /> Fax-813-780-002? <br /> Permit Application <br /> - Date Recewed �--� _ _ Phone Contact for Permit �},?�- q.�-+,2 �q(t3 <br /> Owner's Name cq�rL�alb — C/� rnitll(02 �FJ,�,� -- �� �� � <br /> Owner's Phone Number <br /> Ov�ner'sAddress �d p��C� �N�y [��Ij <br /> I <br /> Fee Simple Titleholder Name �� �� f� <br /> Titleholder Phone Number u <br /> Fee Simple Titleholder Address <br /> -_,m:.;_ ._. .: ,. <br /> �.. _�. _:. -- . <br /> �_�. -- =.°".-- . _., <br /> Job Address 3 gaa�a �CiN,QS/ v2 � <br /> Lot# � <br /> Sub Drvision <br /> _ -- - Parcel# � <br /> � Bio-Hazard Waste Storage-ANNUAL � ►iazardous Material(Tier II or RQ Faality)ANNUAL <br /> � Comm Exhaust Kitchen Hood/DuCt � Hood Installation <br /> � Controlled Burn Q LP/Natural Gas-Installation <br /> � Emergency Generator�30 kw Q LP/Naturai Gas-ANNUAL Sale <br /> � Emergency Generator>30 kw � Places ofAssembly-<�NNUAL <br /> � Fire Protectior.Maintenancz-ANNUAL f—'-1 <br /> try emi � er �J Recreational Bum /1 �� ` <br /> ,�% �� �� <br /> Sprinkler ��/ <br /> � � � � �,.� � Sparklers <br /> Fire Aiarm � ❑ ❑ ❑ � ❑ Sprinkler System Installations <br /> Hood Cteaning � ❑ C ❑ � � Standpipes(Sprinkler Sys) <br /> Nood Suppression � O ❑ ❑ C� � Torch Roofing/Tar Kettle <br /> QFfre Alarm Installation a Waste Tire Storage ANNUA� <br /> � Fire Pumps <br /> � Fire Works <br /> � Flammable Application-ANNUAL �� <br /> � Valuation of Project <br /> Fuel Tanks <br /> Q Other <br /> _.. ... � <br /> Contractor -- - -' - -- _.. :_�,_ ,_. _._. _ , — <br /> S�ynature Company �o,�� <br /> e I�•1.;�,•� <br /> Registered Y/N Fee Current Y/N <br /> �aaress 3g3} � ,�,o„ <br /> �icense# q�85�gp� ���z <br /> CLECTRICIAN <br /> Signature Company �— <br /> Registered Y/N Fee Currerit Y/N <br /> Address <br /> License# �—'1 <br /> PLUMBER _J <br /> Signature Company <br /> Registered Y/PJ Fee Current Y/N �J <br /> Address <br /> License# �— � <br /> MECHANICAL <br /> S�gnature Company <br /> Registered Y/N Fee Current Y/N —, <br /> Address <br /> License# � <br /> GTHEF ; <br /> ;g ' Company <br /> : ra`ur� <br /> Registered Y/N Fee Current Y I N <br /> Address � � <br /> Cirec'�ons. <br /> License# � <br /> Fill out application Completely <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over 52500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply rivo(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Farcel#-obtained from Property Tax Notice(ht�p:/lappraiser pas�Agov com) <br />