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813-780-0020 City of Zephyrhiits Fire Fax-s13-780-002�
<br /> .- Permit Application
<br /> Dale Received � -- - - - - - ,-- • -- _ - ,---- -. :. -__:.. . ,.:
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<br /> Phone Contact for Permit
<br /> Owners Name .. `. .^-.`- -`.`. --f Owna�'s Phone Number �i � �
<br /> ow„ers naaress � QUl `
<br /> Fee Simpte TiUeholder Nama TitlehoEder Phone Number C� � �
<br /> Fee Simple Titleholder Address
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<br /> Job Address � < < � Lot#
<br /> Sub Divisfon Aarcel#
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<br /> � 81aHazard Waste Storage-ANNUAL a Fumigatlan Tent
<br /> � Comm Exhaust Iqtchen NoodlDuct a Hazardous Material(Tier II or RQ Facllity)ANNUAI.
<br /> aConlrolled Bum a Nood fnstallation
<br /> aEmergency Generetor<30 Icw � LP/Natural Ges-installation •
<br /> Emergen�yr Generaior>30 kw LP1Nafural Gas-ANNUAL 8ate
<br /> a Fire ProlecUon Ma(ntenance-ANNl3AL � Piaces of Assembly-ANNUAL � ( �
<br /> � em� � er ,� ( �
<br /> Sprinkier � ❑ ❑ ❑ � � Recreallonal Burn
<br /> Fire A18trtt � C] � �!►� � Sperklers
<br /> Hood Ciean(ng � O ❑ ❑ � � Sprinkter System tnslaRadons
<br /> Hood Suppression � ❑ ❑ ❑ � � Standplpes(Sp�inkler Sys}
<br /> Q Fire Aiarm instetlatian � Torct►Roofing/Tar Kettle
<br /> 8 F(re Pumps Q Waste Tire Starage ANNUAL
<br /> Fire Works
<br /> � Flammable AppliCaUon-ANNUAI. Valuafion of ProJect
<br /> aFue1 Tanks
<br /> Q Other: •
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<br /> ConUactor Company �
<br /> 8fgnature �. Reglstered Y/N Fee Current Y!N
<br /> Address License# �
<br /> ELECTR4CIAN Company ,
<br /> signBture Reg€atered Y/N Fee CurreM Y/N
<br /> Address l.tcense# I
<br /> PLUM9�R Company
<br /> Slgnature ' Reglstered Y/N �ee Current Y/N
<br /> Addreas License# --
<br /> MECHANICAL Company
<br /> Signature Registered Y/N Fee Cunent Y/!�
<br /> Address Llcense#
<br /> O7HER Company
<br /> Signature Re9tscered Y/N Fee currenc Y 1 N
<br /> Address ' Llcense#
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<br /> Dlrectlons:
<br /> Fill out applicatton compfetely.
<br /> Ovmer&Contractor slgn back of appiicaGon,notsdzed(Or,copy of slgned coniract wilh owner}
<br /> If over$2500,a Notice of Commencement ts requfred(Mechanicaf work over$5000)
<br /> Supply lwo(2)sets of drawinga with applicable documentaUon
<br /> Altow 10-14 daya for revlew after submittal date. Pareel ii-obtalned from Property Tax NoUce(hllp:l/apprafser.pascogov.cam)
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