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8�3-780-0020 Ciry of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received r Phone Contact for Pertnit �� � � <br /> , r-+--�,--- _ <br /> vmer's Name • Owner's Phone Number � � � <br />�wner's Address � � � � � <br /> ee Simple Titleholder Name Titleholder Phone Number � � <br /> ee 5imple Titleholder Address <br /> _ _ _ _ . -, L;;�, -. . - - " ti'43.-^"*v.5.. .�.v �...4., ...�... ..- <br />�b Address 3 � Lot# � <br /> ub Division Parcel# <br /> �._ . ...,,�_. ��.�.�...�- -�..�*,-,. _�. .: ._. • ..,_ - .- , f:_.� „ �.-�a�,���= u-��,x���� -.- . �. <br /> a Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct Q Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum a Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Instatlation <br /> � Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> �y emi �n er <br /> Sprinkler � ❑ � ❑ � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ � ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � 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 /> � Fuel Tanks <br /> Q Other: <br /> - w,. � �; _ - ..g.��_t , . . . ....�..>: . .. . , .. � , _ . , .- w_�. � ,Y-- ,�>... �,�; r��,, .-��: . .. .�, <:� <br /> ontractor " Company <br /> ignature �Z�L�-� Registered /N Fee Current Y/N <br /> Address License# <br /> LECTRICIAN Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> LUMBER Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> IECHANICAL Company • <br /> ignature Registered Y/N Fee Current Y/N <br /> Address License# <br /> THER Company <br /> ignature Registered Y/N Fee Curcent Y/N <br /> Address License# <br /> irections: <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(Mecha�icat work over$5000) <br /> Supply two(2)sets of drawings with appiicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />