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a;3-�saoozo City ofZephyrhiltsFire�•- -. �Fax-813-780-0021 <br /> Permit Application _ <br /> Date Received ' Phone Corrtactfor Pertnit <br /> Owner's Name ��� /�� s� 4 Owners Phone Number � � � <br /> Owner's Address �3d �ll ��1�� <br /> Fee SimpleTitleholder Name Titleholder Phone Number � � � <br /> Fee Simple TlUeholder Address <br /> Job Address Lot# � <br /> Sub Division Paroel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Factlfty)ANNUAL <br /> � Controlled Bum � Hood Instalfation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generetor>30 kw � LP/Natural Gas-ANNUAL 5ale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL. <br /> ,t�r y emi �"�]n er <br /> Sprinkler � � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alarm � ❑ O ❑ C� � 5parklers <br /> Hood Cleaning � ❑ ,I�' ❑ � � Sprinkler System Installatlons <br /> Hood Suppression � ❑ ❑ ❑ �� � Standpipes(Sprinkler Sys) <br /> � Fire Atarm tnstallation � Toroh Roofing/Tar 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 /> Corrtractor Company � <br /> 5ignature Registered N Fee C nt Y/N <br /> Address ! License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address , License# <br /> PLUMBER Company _ <br /> Signature Rsgistered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature � Registered Y 1 N Fee Curtent Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registerad Y/N Fee Current Y/N <br /> Address License# <br /> Directions: <br /> FII out applieation completely. <br /> Owner 8 Corttractor sign back of application,notarized(Or,copy of signed contrect with owner) <br /> ff over$2500,a Notice of Commencement is required.(Mechanical work over$5000) <br /> Supply 1wo(2)sets of drawings wRh applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(httpJlappraiser.pascogov.com) <br />