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813-780-0020 Ciry of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> te Received ��—� Phone Contact for Pertnit C� �� C� <br />✓ner's Name �-J�v2-<L�4z�/� � Z l����' S Owners Phone Number �3 7 � LSL=—J <br /> vner's Address ��Z� �2Y � <br /> e Simple Titleholder Name Titleholder Phone Number C� � �� <br /> e Simple Titleholder Address <br /> w- - - � - - - n;._^tw'.x�'::r, � :^.u='�:''^- - <br /> b Address ��1'''""� ��S � g�'v� ~ Lot# U <br /> ib Division Parcel# <br /> �_.. �.,,,. .. . � . . m.�,. . . ._ - ._ ., _. � _ .. ,»•._,,, z_�:�.,,,�,,N;�:a.�.,, f-e.;� , s�,._ , , <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 � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> � emi � er <br /> Sprinkler � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � 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 /> . __..' ` - .. _.._ �.,.. . �-r w . . , ...., . - . - ` , " .., _ _, y""�'f.� Y^-y.er ..y»x.y�.V{'4' . ""�8°W-,�� ° ..<. . <br /> ontractor • c��1��6'7�6�0�( Company ��+���'�'7 'tK_e � -�v2�cu- <br /> ignature Registered Y/N Fee Current Y/N <br /> Address �3 �^` � i +'KOS3►ss °' �`v� � License# C�+�- l on"� 'i1� <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 Current Y/N <br /> Address License# <br /> irections: <br /> Fill out application completely <br /> Owner 8 Co�tractor 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:!lappraiser.pascogov.com) <br />