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i s-�ao-oozo City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received ,� � • � ` Phone Contact for Permit � � � <br /> Tf � a�^^�'^^Tq±�`e� <br /> �wner's Name ✓ Lf S '� ��� Owner's Phone Number C� � � <br /> tivner's Address 'Z 5 ro G�-�t �✓L✓ z���}Y�17�1'Z L f /c'/ 3 3 J Y Z � <br /> ee Simple Titleholder Name Titleholder Phone Number � C� � <br /> ee Simple Titleholder Address <br /> L�J <br /> - - ..- _ . ' r.�.-- ,�a < -� . <br /> �b Address � <br /> Lot# <br /> ub Division Parcel# <br /> �- •--� __.,�.. ,...�,... .».— _.'°r zia >.y.5. r,hr.r. H,.a-4nn._. .�_• x ..;P, = :...,.,. _.,r .�:r-9, .�...�,:c,,u1�.r r.-«pias-:P�,�y�'" �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 /> aFire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> ��y emi � er ❑ <br /> Sprinkler ❑ ❑ Recreational Bum <br /> Fire Alartn � p ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ p ❑ �� � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation a Torch Roofing/Tar Kettle <br /> � Fire Pumps � Wasie Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br /> ontractor , -- - " ,. . _ °>. ,.f.,, _� .� > _. ° -,- , ,. _ . . -�K, -�.r: t.s>p,; ,-.:..._�,; <br /> -, �� < ;� <br /> Company <br /> ignature ��- � � � e <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> LECTRICIAN <br /> Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> LUMBER <br /> Company <br /> gnature Registered Y/N Fee Curcent Y/N <br /> Address <br /> License# <br /> ECHANICAL <br /> Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> fHER <br /> 3nature <br /> Company <br /> Registered Y/N Fee Cunrent Y/N <br /> Address <br /> - License# <br />�ections: <br /> Fill out application compietely <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 work over$5000) <br /> Supply two(2)sets of drawings with applicabie documentation <br /> Allow 10-14 days for review after submittal date Parcel#-obtained from Pro ert Tax Notice htt //a <br /> P Y ( P• ppraiser.pascogov.com) <br />