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813-780-0020 City of Zephyrhilts Fire Fax-813-78U-0021 <br /> , Permit Applicatlon <br /> Date Received 8' Z!� 2.. Phone Contacf tor Permit <br /> - - � -- - ... -:_-.. ._. ,_. ._ ,. <br /> - - - --- - -------- <br /> Ownefs Name �QR%` � � Owners Phone Number � � � <br /> Owner's Address 7�.jU (?' � /�� •�G KL.� �L• 3 ,�' � <br /> Fee Simple Tit�eholder Name ?idehotder Phone tJumber � � � <br /> Fee Simple TtUeholder Address <br /> _ ... _ __ _ _ _ :- ---- - <br /> ...---- <br /> •------ - � --.-___-�---_-..-:.-.____:_----__'_ ,.-- --_- -:-- �.- •-- - - - ....._._ <br /> - - --- _._._ .. :... __- : _:_._....._- � <br /> Job Address lot# <br /> Sub Divisfon Parcel# <br /> - . - - ---- -- -�— -- - --- ------ -- -- --- <br /> � SlaHazard Waste SioraBe-ANNUAL � Fumigation Tent <br /> � Comrr►Exiiaust Kitchen Hood/Duct � liazardous Maleriaf(7ier If or RQ Faaiity)ANNUAL <br /> � ConVo1(ed Bum a Hood Installetion <br /> � Emecgency Generator<30 kw � LPlNalural Ges-installation / � <br /> � Emergency Generator>30 kw � LP/Natural Gas-/WNUAL 3ale (/� <br /> d <br /> � Fire Protectton Maintenance-ANWUAL � Ylaces of Assembly-ANMUAL �� <br /> �y emi � er � � <br /> Sprinkler � ❑ O � � � Recreallonal Bum <br /> Ffre Atarm � ❑ � ❑ � � Sparkfers <br /> Flood Cteaning � ❑ CI L7 � � Sprinkier Systam Inslallations <br /> Hood Suppression � O O ❑ � � Slendpipes(Sprinkler Sys) <br /> � Fire Aiarm Installation o Torch Roofing/Tar KatUe <br /> � Fire Pumps � Waste Ttre Storage ANNUAL <br /> � Fire Works <br /> � Flammable AppiicaGon-ANNUAL Valuation of Project <br /> aFuel Tanks <br /> 0 othe�: <br /> -- - - - - <br /> , ., . . ___ _._ .. --- - - - - - -- =-- -_ ----- - _-- -- -- ._ -- . - _ . -- ---; <br /> Contractor � Company i�+ ,r�'Il►�l <br /> Signature Registered Y/ Fee Current Y/N <br /> Address Lfcense# <br /> ELECTRICIAN Company <br /> Signature � Registered Y/N Fee Current Y 1 N <br /> Address License# <br /> PLUMBER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fes Current Y/N <br /> Address license# <br /> O7HER Company <br /> Signature Registered Y/N Fee Curreet Y/N <br /> Address License# <br /> .-- - -- -- __ _ - - <br /> - - _,_,_.,. .-------._. ..__ . . _ .. ---- -- - - -- -- - <br /> DUeciions: <br /> Fill out epplication completely. <br /> Owner&Contractor sign back of appiicalion,notarized(Or,copy of signed contract wiih owner) <br /> If over$2500,a t�otice of Commencement is required(Mechaoical work over$5000) <br /> Supply two(2y sets of drawings wilh appllcabte documentation <br /> Atlow 19-14 days for reriew aker submitEal date. Parcel#-obtained from Property Tax Notioe(htfp:l/appraiser.pasoogov.com) <br />