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813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br />)ate Received ' �r "a-L.—! z Phone Contact for Permit <br />���..����-��. �.,�uati���.�, ,���_ . <br /> hNner's Name � � �C ��� Owners Phone Number � � C� <br /> hnner's Address ���� S�� ��u� G A <br />�ee Simple Titlehoider Name Titleholder Phone Number � C� C� <br />�ee Simple Titleholder Address <br />�..,� w=,::_�:, _ �� <br />�ob Address �-�f ( J� �-�`-� lot# <br /> iub Division Parcel# <br /> m rr..��: " <br /> a Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> aControlled Bum � Hood Installation <br /> aEmergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale ���� <br /> � Fire Protection Maintenance-ANNUAL Places of Assembly-/WNUAL �� <br /> � emi � er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alarm � ❑ ❑ (� � � Sparkiers <br /> Hood Cleaning � O O ❑ �� � Sprinkler System Installations <br /> Hood Suppression � O ❑ ❑ � � 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 Valuation of Project <br /> QFuel Tanks <br /> Q Other• <br /> �. ,_... ,. ��� ��+.�:���,r >;���:�.,�E�� <br /> Contractor Company v �.+� 'r�� <br /> Signature Registered N Fee Gurrent /N <br /> Addres .Q, ��c !4S' Sc�F�✓-�l �c- License# G�G�lJ.5�3/ <br /> ELECTRICIAN Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Curcent Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee�urrent Y/N <br /> Address 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://appraiser.pascogov.com) <br />