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eisaeo-oo2o m���'� �YL_.--�- City of.Zephyrhiils�Fir:e• FaX-sis-�so-ooz� <br /> � T <br /> ; Pe it Application <br /> �ate Received fi U� �� ���� - Phone Contact for Pertnit �� J�L T 93 j <br /> '.."�+t;.w...:.e�.:.;e.��i'�k; .�.w..,,...�..n..w�....�.�.,. -—,�.=r,.. <br /> -��d� ;a''r. +�-+r. - -.,c�.�_� <br /> s,z��..._ t���'�r — � .�:o�..._...�._�...Y_ <br /> )wner's Name Owner's Phone Number [��� .S�fS . �35� <br /> )wners Address ��, �c�1( q 73� Tr9Mf�J �L ?j��j 7� <br /> ee Simpie Titleholder Name Titleholder Phone Number [� � �� <br /> ee Simple Titleholder Address <br /> �_�`v'^'��'�...'n'a'�c'�: �...,.,.w...��f7' a:. .:m - <br /> �i// ' .n._-�r��t�`w'�" <br /> ob Address �����Q S� ���L� ���� l97,/� �j�D, Lot# �j <br /> �ub Division Parcel# <br /> �: <br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood installation <br /> aEmergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generetor>30 kw � LP/Natural Gas-ANNUAL 5ale <br /> � Fire Protection Maintenance-Afy'NUAL � Places of Assem6ly-ANNUAL <br /> ❑ r y emi � er a <br /> 5prinkler ❑ ❑ O RecreaGonalBum .� <br /> Fire Alarm � O ❑ ❑ C7 � Sparklers � (� <br /> Hood Cleaning � ❑ L� ❑ C� � Sprinkler System Instailati�,ns � � <br /> Hood Suppression � ❑ ❑ ❑ � a Standpipes(Sprinkler Sys� <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL � Valuafion of Project <br /> Fuef Tanks <br /> aOther: <br /> �ontractor � Compa�y f � � 5�,� �S' <br /> 5ignature Registered Y/N Fee Curtent Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> PLUMBEF2 <br /> Compa�y <br /> Signature Registered �'/N Fee Currer�t Y/� <br /> Address <br /> License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> OTHER <br /> Signature <br /> Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> Directions: - - <br /> Fill out application completely <br /> Owner&Contractor sign 6ack of application,noWrized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Comme�cement is required(Mechanical woric over$5000) <br /> Supply 1wo(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review aker submittal date. Par�el#-obtained from Property Tax Notice h J/a <br /> ( ttp ppraiser.pascogov.com) <br />