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n,isasaoo2o City ofZephyfiilis'Fir��-.�=- �Fax-813-7g0-0021 Permit Application _ Date Received - Phone Contacfifor Pertnit Owner's Name 77� � ,,�/ G Owner's Phone Number .� �� Owner's Address O -- 1'�� f/� Fee SimpleTitleholder Name Titleholder Phone Number � C� � Fee Simple Titleholder Address Job Address Lot# � 5ub Division Paroel# � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Faciflty)ANNUAL � Controlled Bum � Hood Instailation � Emergency Generator<30 kw � LP/Naturel Gas-Installation Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Saie / � Fire Protection Maintenance-ANNUAL � Piaces of Assembly-ANNUAL / 3Q ,� �y emi �n er '� � 5prtnkler � � O ❑ ❑ � � Recreational Bum � Fire Alartn � O ❑ ❑ � � Sparklers Hood Cleaning � � ❑ O � � Sprinkler8ystem Installations Hood Suppression � ❑ � O � � Standpipes(Sprinkler Sys) � Fire Alartn Installation � Toroh Roofingffar Kettle Fire Pumps � Waste Tirs 5torage ANNUAL Fire Works Flammable Applicafion-ANNUAL r--, Valuation of Project Fuel Tanks Q Other: Contractor Company � C Signature Registered N Fee Current Y/N Address ) License# ELECTRICIAN Company Signature Registered Y/N Fee Current Y/N Address License# PLUMBER Company Signature Registered Y/N Fee Currerrt Y/N Address License# MECHANICAL Company Signature Registersd Y/N Fee Curtent Y/N Address License# OTHER Company Signature Registered Y/N Fee Cuneni Y/N Address License# Directions: FII out applieation completely. Owner 8�Corrtrzctor sign back of application,notar¢ed(Or,copy of sfgned contract with owner) If over$250�,a Notice of Commencement is required.(Mechanical worlc over$5000) Supply iwo(2)sets of drawings with applicable documenta6on Allow�0-'14 days for review after submittal date. Parcel#-obtained from Property T�Notice(http:/lappraiser.pascogov.com)