Laserfiche WebLink
813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> , Permit Application <br /> ate Received � �� �Z Phone Contact for Permit �� Ot � �Q� <br /> wner's Name ` C .J Owner's Phone Number � � C'�� "t� <br /> wner's Address � � L h ('� � I S ` ' <br /> �e Simple Titleholder Name Titleholder Phone Number r-� � � <br /> :e Simple Titleholder Address <br /> ,b Address (�N P( p,� 3 b � �jp �f� P • � Lot# C� ', <br /> �b Division Parcel# ��� r�(� � � �3�� <br /> � Bio-Hazard Waste Storage-ANNUAL � Hazardous Material(Tier II or RQ Facility)/�NNtfAL-. <br /> � Comm Exhaust Kitchen HoodlDuct � Hood Installation � <br /> � Controlled Bum � LP/Natural Gas-InstallaUon ��, , �� <br /> � Emergency Generator<30 kw � LP/Natural Gas-ANNUAL Sa� �� � <br /> � Emergency Generator>30 kw � Places of Assembly-ANNU L�� � � <br /> � � �� <br /> Fire Protection Maintenance-ANNUAL Recreational Bum ;°� <br /> �y emi �n er <br /> ����Q(,� Sprinkler � ❑ ❑ ❑ � � Sparklers <br /> (ZbQ„ Fire Alarm . ,.�=���""""'�� ❑ ❑ p- �_ � Sprinkler System Instailations <br /> �l �-� , � � <br /> fibod Clea�i� ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> r Hood Su ression <br /> PP Q � Torch Roofi�glfar Kettle <br /> � Fire Alarm Instaliation � Waste Tire Storage ANNUAL <br /> � Fire Pumps <br /> � Fire Works � <br /> � Flammable Application-ANNUAL Valuation of Project <br /> aFuei Tanks <br /> � � Other: <br /> � � �� <br /> ��0� ' Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Addtess ' <br /> License# <br /> _ECTRICIAN ��� 4� ��� 1,I Company <br /> gnature 1 Registered Y/N Fee Current Y/N <br /> Address License# <br /> _UMBER <br /> Company <br /> gnalure Registered Y/N Fee CuRent Y/N <br /> Address <br /> License# <br /> ECHANICAL Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> THER <br /> Company <br /> gnature Registered Y/N Fee Curcent Y/N <br /> Address <br /> License# <br /> irections: <br /> Fill out appliption completely <br /> Owner&Contractor sign back of appUption,notarized(Or,copy of signed contract with owner) <br /> If over a2500,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 /> 4� `��:� _�iiE <br /> ,m a � <br /> � �►�� ��: _ �,�„ , <br /> V�li��S'i� � y ,71 I ��I I {.'',�e �' . <br /> l'3 r °� <br /> g+�. � <br />