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- sisaso-oo2o City of Zephyrhiils Fire Fax-813-780-002�
<br /> Permit Application
<br /> Qate Received �Q•���/ � Phone Contact for Permit �,Z'� qy� 1 q
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<br /> �wner's Name �LG-CT �y,SjCI�(� �(�f�Qy pwner's Phone Number dl?f 7�� ?j/�'7
<br /> �v��e�:;Address l�d'3� �'l�v�e�e �,�r.0 Lau� 7�oH,�,��ee s �L 335"�f/ �
<br /> Fee S�mple Titlehoider Name � I � �
<br /> Titlehotder Phone Number J
<br /> Fe::S�mpie TiUehoiderAddress
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<br /> Sub Division
<br /> Parce�#
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<br /> Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier 11 or RQ FaciJity I ANNUAL
<br /> � Comm Exhaust Kitchen Hood/Duct � Hood Installatfon
<br /> � Controlled Bum a LP/Natural Gas-Instaliation
<br /> � Emergency Generetor<30 h,N a LP/Natural Gas-ANNUAL Sale
<br /> � Emergency Generator>30 kw � Pia�;es of Assembly-ANNUAI
<br /> aFire Protection Maintenance-ANNUAL � Recreational Bum �
<br /> � r y emi � er � � �
<br /> Spnnkler � � � � ❑ t� I
<br /> Sparklers d
<br /> Fire Alarm ,,,t
<br /> � � J�'+ � � Sprinkler System Instailations
<br /> Hood Cieaning � p ❑ ❑ � � Standpipes(Sprinkler Sys)
<br /> Hood Suppression � q p p � � torch Roofing/Tar Kettle
<br /> � Fire Alarm instailation � Waste Tire Storage ANNUAI
<br /> � F�re Pumps
<br /> � Fire Works
<br /> � Flammeble ApplicaGon-ANNUAL
<br /> � Valuation of Project
<br /> Fuei 7ank5
<br /> ❑ Other:
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<br /> S�gnature Company T' .}.,u� (u�1'O ,�
<br /> Registered Y/N Fee Current Y/N
<br /> Address 35 31 KQ �.}�pAe Rd.
<br /> License# �F 0000 y�l t �
<br /> ELECTRICIAN -
<br /> S�gnature Company
<br /> Registered Y/N Fee Current Y/N
<br /> Atltlress �
<br /> License# �
<br /> PL'JM6ER
<br /> S�gnature Company
<br /> Registered Y!N Fee Current Y/N
<br /> Adoress
<br /> License# �—� �
<br /> MECHANICAL
<br /> S�gnature Company
<br /> Registered Y J N Fee Current Y/N
<br /> Adaress
<br /> license# � �
<br /> OTHER
<br /> Cignature Company
<br /> Registered Y/Ti Fee Current Y/N
<br /> Address
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<br /> Fill out apphcation completely .._..�.'- --. _ . . _ ._ __ .,
<br /> Owner&ConUactor sign back of application,notarized(Or,�py of signed contract with owner}
<br /> it over 52500,a Notice of CommenCement is required(INe�hanical work over$5000)
<br /> Supply two(2)sets of tlrawmgs with appliCable documentation
<br /> Auow 1a�4 days for review after submittal date.
<br /> Parcel#-obtained from Property Tax Notice(http:!/appraiser pasco,yov com)
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