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a��-�ao-oo2o City of Zephyrhilis Fire Fax-813-780-0021 / <br /> Permit Application <br /> �Received �// -s�l'L, <br /> Phone Contact for Pertnit $( �$c� '� /"7 <br /> iers Name � ` Owner's Phone Number �_� � � <br /> iers Address 7�33 V—��� l� '�'?) Z <br /> Simple Titleholder Name � TiUeholder Phone Number U C� �� <br /> Simple Titleholder Address <br /> Address �GL-�/l�-i`�" �� <br /> Lot# <br /> Division Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigatlon Tem <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood InstallaUon <br /> � Emergency Generetor<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 �n er ��� <br /> Sprinkler ❑ ❑ ❑ � � Recreational Bum <br /> Fire Alartn � O ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ � C� ❑ <br /> Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> a Flammable Application-ANNUAL <br /> � �-1 Valuation of Project <br /> Fuel Tanks <br /> Q Other. <br /> treccor - <br /> Company � � <br /> iature �` �� � �i <br /> Registered Y/N Fee Current Y/N <br /> Address L>,(� [.cc.� � t (� License# <br />:CTRICIAN � �mpany <br /> iature I Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> MBER <br />�ature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />:HANICA <br /> ature <br /> Compa�y <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ER <br />�ture Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# '� <br /> tions: <br /> Fill out application completely. <br /> Ovmer&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 /> 5upply two(2)sets of drawings with appiicable documentation <br /> Allow 10.14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appreiser.pascogov.com) <br />