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a�s-�ao-oo2o City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Rece.�ed � �% ' y��/a Phone Contact for Permit � � � <br /> a i ; y x , <br /> vaner's Name c• Owner's Phone Number � � � <br /> rovner's Address � e �j� � � ZP � <br /> ee Simple Titleholder Name Titleholder Phone Number � � � <br /> ee Simple Titleholder Address <br /> - " , _ °r..: Y _.,�zr. -m- ,. . . <br />�b Address � <br /> Lot# <br /> ub Division Parcel# <br /> - - - - -'a,.�,.yr;._ . .,. .. -.�.r-.��, k.Y�. , ..,,n. , ,. -,c��- -� � ., . i� , ,. - � <br /> - . ,.rt }. ,o-_ _.'�.< w:.et3a'.�4i'a'.-9&��r.T,-,i'. �.�yRi..r p;;t" _ � ' <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent . <br /> Q Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facrlity)ANNUAL <br /> aControl�ed Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL �Dhaces of Assembly-ANNUAL <br /> r y emi �n er <br /> Sprinkler � ❑ ❑ ❑ B � Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ 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 /> � Fuel Tanks <br /> Other: <br /> -- _ _ , ._. � _ , . , _ . ,. � � •�,__,-rr� T.. . �� .�.�r , -��, � ,.. _., : <br /> ontractor <br /> Company <br /> ignature GZ�(�c Registered Y/N Fee Current Y/N <br /> Address License# <br /> LECTRICIAN Company <br />�gnature Registered Y/N Fee Current Y/N <br /> Address License# <br />_UMBER <br /> Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ECHANICAL Company • <br /> gnature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> fHER Company <br /> gnature Registered Y/nl Fee Cunrent Y/N <br /> Address License# <br /> rections: <br /> Fill out application completely <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical woric 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 />