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813-780-0020 City of Zephyrhilis Fire � � 1 L),� Fax-813-780-0021 <br /> /iv <br /> ' Permit Application <br /> ate Received �� �� Phone Contact for Pertnit ��' � yU 1 �� <br /> nmer's Name ' �/�Cb / 7/�� •� C/t ti Z Owner's Phone Number C] � � <br />�nrner's Address ���� 'y �1 <br /> je Simple Titleholder Name TiUeholder Phone Number � � � <br />;e Simple Titleholder Address <br />�b Address /f/ Lot# � <br />�b Division Parcel# �� '� -•���0 ���L� ' <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LPlNatural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum �M <br /> Fire Alarm � � ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations "` <br /> Hood Suppression � � ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps a Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL , Valuation of Project <br /> Fuel Tanks <br /> �6ther. - � t5 .•3 <br />�ntrector Company ✓rc� _ �'lv%1• <br /> gnature � Registered Y/N Fee Current Y <br /> Address License# <br />_ECTRICIAN Company <br /> gnature � Registered Y/N Fee Curtent Y/N <br /> Address License# <br />_UMBER Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br />_CHANICA Company <br />��ature Registered Y/N Fee Current Y/N <br /> Address License# <br /> fHER Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> rections: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized(�r,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation ;tU�B�iI'�'�D� �IV(S�HAVE BEEN�EVIEW� <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Pro�eYyZEP�ice L$p�ir iser.p�AQgpy,c��S OF'FICE <br /> �r�IRF,M 1tJYl <br /> Date: a 7�l� � <br /> :iev:ewer: _�__ <br />