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� 813-780-002Q City of Zephyrhilis f-ire rax-�,i,s-�nu-uun <br />� Permit Application <br /> y�te Receivr,�� ° ?jF ��-1 Phone Contact for Permit �� '� '�I <br /> � <br /> ;wner's Name w S Q � � Owner's Phone Number �3 � �3� <br /> ��ner'sAddress ✓�� �� —� ` �v� 2� ��r I��S � � 335yz <br /> S � � � <br /> �e Simple Titleholder Name Titleholder Phone Number <br /> 1�e Simple Titleholder Address <br />�'. <br />�' 3�i � 15 t�`'` f��� Z�e h rh� Ils � Z �� <br /> ib Address 3,3,5� Lot# <br />� �b Division Parcel# <br />� � Bio-Hazard Waste Storage-ANNUAL a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Comm Exhaust Kitchen Hood/Duct � Hood Installation <br /> � Controlled Bum � LP/Natural Gas-Installation j��, ��f � <br /> � Emergency Generator<30 kw � LPlNatural Gas-ANNUAL Sale r r� <br /> aEmergency Generator>30 kw � Places of Assembly-ANNUAL � � <br /> � Fire Protection Maintenance-ANNUAL � Recreational Bum �_._. <br /> �y emi � er <br /> �� Sprinkler � ❑ ❑ ❑ � � Sparklers <br /> Fire Aiarm � ❑ ❑ ❑ � � Sprinkler System Installations <br /> s�q 1 rL Hood Clea�ing ❑ ❑ ❑ � Standpipes(Sprinkler Sys) <br /> 7:Q�Am Hood Suppression ❑ ❑ ❑ � Torch Roofing/Tar Kettle <br /> j Q Fire Aiarm Installation � Waste Tire Storage ANNUAL <br /> � Fire Pumps <br /> � Fire Works <br /> � Fiammable Application-ANNUAL r— � Valuation of Project <br /> � Fuel Tanks <br /> Q Other� <br /> �ntractor �/�,�N� v (�� � � ^, � Company �—� <br /> Vl <br /> gnature Registered Y/N Fee Current Y/N <br /> Address ,j�� s�t�-(-: ''7�f�•�-�12'° '� ' .���`:� �� � license# <br /> �- - <br /> _ECTRICIAN �p/ Company <br /> gnature <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> _UMBER <br /> Company <br /> gnature Registered Y!M Fee Current Y/N <br /> Address <br /> License# <br /> ECHANICAL Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> THER <br /> Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address � � <br /> License# <br /> �rections: ' <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed�ontract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> 5upply two(2)sets of drawings with appiicable dxumentation <br /> Allow 10-14 days for review aRer submittal date. Parcel#-obtained from Property Tax Notice(http://appr8iser.pascogov.com) <br /> �� ��� <br /> I�er�id�.�lt�t �� �' ��.1 C 1!� <br /> P.#�►.��� i� � <br /> P: �': <br /> g <br />