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813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received �— `�/�� e Phone Contact for Pertnit � _3 _ � A�, �� <br /> �wner's Name / ��/� J Owners Phone Number � � � <br /> tivner'sAddress Ci ij.t(,�.i/C �� � y'jjv,+✓1/� ��� <br /> ee Simple Titleholder Name ' ,G " ,�j�Q�f/,!� f.,.'jL- Titleholder Phone Number C� � � <br /> ee Simple Titieholder Address � <br /> - - --- � ' - - �;r��.- - — ��:., - . ._ . - - <br /> - - =.::.�s'�.�. -:'.'�.4.a*.�°.�+-.r'�5;. ."�-4^-.�^a �€..•-�� , <br /> �I�Address J / '�' �//� S ^ � Lot# � <br /> ub Division Parcel# <br /> ` - _'�•�-. _. _�,��.�>... .. �-��__ a,-�,..,. �._.. F„:�...,._s:,,�.; <br /> . �4-._ -'S:??.°xN'3�,'R- -ti%4%i&.�aia 3f°�=.�1&:.��`.�,t ry.r. _ .x� - . <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 a Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation � ; <br /> a Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale �� <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUqL �� <br /> r y emi �n er '' <br /> Sprinkler � ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers �'� <br /> Hood Cleaning � ❑ O ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ � ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation Torch Roofing/Tar Kettie <br /> � Fire Pumps � Waste Tire Storage ANNUAL /�� /� )�,� <br /> � Fire Works ��� 1!�I � 7' � <br /> f <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br />- - ,. . :. ,..t �:, � <br /> - -_ _ , �_ . . . . <. >.�•,�:.::�,. . :. , <br /> • _. . _. .. ._ .,�.`�-11'.. - ;9.:-n'p YS�±Y�..i�?!e(+F�,T. <..4�.�.: . <br /> - . «-...._ s_r <br /> ontractor r� `�4"I'{L�� Company . �,�,e� . . <br /> ignature Registered Y/N Fee Current Y/ <br /> Address <br /> license# <br /> LECTRICIAN Company <br /> ignature Regislered Y/N Fee Current Y/N <br /> Address License# <br /> LUMBER <br /> 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 <br /> Company <br /> ignature Registered Y/N Fee Current 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(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://appraiser.pascogov.com) <br />