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813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit �� ��,J I '/�c2 <br /> Owner's Name Qlr Owner's Phone Number � � �� <br /> Owner's Address � � � � � � <br /> Fee Simple Titleholder Name Titleholder Phone Number � �� �� <br /> Fee Simple Titleholder Address <br /> Job Address J C- I�J vC., L 33��- Lot# � <br /> Sub Division Parcel# ��'�.P'Z� '����'� oo ��"�� <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Materiai(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> aEmergency Generator<30 kw a LP/Natural Gas-Installation <br /> � �� LPitJatural Gas-APJNUAL Sale <br /> Emergency Generator>30 kw LJ <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL � <br /> ❑ r y emi �n er ❑ � 2j <br /> Sprinkler ❑ ❑ ❑ Recreational Bum �I � <br /> Fire Alarm ❑ O � � � Sparklers t <br /> Hood Cleaning � � � � � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ �� � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> a Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL �_-, Valuation of Project <br /> � Fuel Tanks <br /> Q Other <br /> Contractor Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> PIUMBER Company <br /> Signature i Registered `�(N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> OTHER 1 r Company ' `� <br /> Signature a5 �� Registered N Fee Current Y N <br /> Address �, � 1i License# <br /> Directions: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:llappraiser.pascogov.com) <br />