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� s���so-oo2o City of.Zephyrhifls Fire Fax-813780-0021 <br /> Permit Appiication <br /> Date Racaived Phnne Cont�ctfar Parmit / �` <br /> ,�.�a��ra��a;,s���.��a:,..,...,. .,.�..�,.F,�...�..,._. ... .. ,..�.��..n • =�t�.�,....... <br /> Owner's Name 4�C�nJ l � �/�� � Owner's Phone Number �� gZ 'r i rL <br /> Owner'sAddrass � C�O� �— �3z`U� ''P us l`� � � <br /> Fea Simpie Titleholder Name Tifleholder Phone Number � � � <br /> Fee Simple"Titlehoider Address <br /> l�i" � <br /> Lat# <br /> Job Address <br /> Sub Division <br /> Parcel# <br /> Y� <br /> � Bio-Hazard Waste Storege-ANNUAL � Fumigatlon Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazerdous Material{Tier II or RQ Fecility)AMhIUAL <br /> � Controliad Bum � Hood lnstallation <br /> � Emergency Generator<30 kw � LP/Klatural Gas-Irist211ation <br /> � Emergency Generator>30 kw � LP1Natural Gas-ANNUAL Safe <br /> � Fire Prat�ction Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> emi n er <br /> � � � <br /> Sprinkler � ❑ Cl ❑ � Reereational Bum �u r � � � , <br /> =ire Alarr � � 0 ❑ �� Sparklers ��__.-- <br /> od Claanin� � ❑ ❑ Sprinkler System installatians <br /> uppression ❑ ❑ D �� � Standpipes(Sprinkler Sys) <br /> � <br /> � Fire Alartn installation � Torch Rooflng/'far Kettle <br /> Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Worics <br /> Flammahla App{ication-ANNUAL � Valuafion of Project <br /> a 'ruei Tanks <br /> Q C?ther: <br /> ��.��a�;,c,�� <br /> Contractor Campany � /� %��,�,[�, <br /> Signature Registared Y/N Fee Current � Y/N <br /> Address J J �i � License# _� <br /> ELECTRICIAN Company <br /> Signature � Regfstered Y 1 N Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Rsgistered Y/N Fee Gurrsnt Y/ N <br /> Address License� <br /> tvSECHANiCAL Company <br /> signature Registered Y/N Fae Current Y 1 N � <br /> Address Lieanse# <br /> OTHER Company ,_ <br /> Signature Rsgistered Y/N Fee Current Y/N <br /> Address Licsnse# <br /> i,�7.• aae.u�uwW:r�vzm��mo.w �umv�uw�ue�xu..�o....�.m..�., <br /> Directions: <br /> FII out application campletely <br /> Owner&Contrac;or sign bacx of appitcation,notarized(Or,copy af signed contract with ownar) <br /> I;over$2500,a Notice of Commencemerrt is required(Mechanical work over�5000) <br /> Supply two(2j sets of drawings with applicable doeumentation <br /> Aliow�0-14 days for review after submittal date. Parcel#-ohtained rrom Properry Tax Notiee(http:/lappralser.pascogov.com) <br />