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a�s-�ao-oozo City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received' [ � � Phone Contact for Permit 7� �� dT3 ' <br /> Owner's Name �(j' QS � L jj � �s (�C.p� ��aMone Number � � �� <br /> Owner's Address � o�3 3 p�.r B� <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> Job Address Lot# �� <br /> Sub Division Parcet# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct a Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> aEmergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw ' � LP1Natural Gas-ANNUAL Sale � � /� <br /> � �} <br /> Fire Protection Maintenarice-ANNUAL � Piaces of Assembly-ANNUA� � �� (/ <br /> tny �ni ',i �n i ti-�Cr <br /> Sprinkler �r ❑ ❑ � � Recreational Burn <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � O ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> � Other <br /> Contractor Company i7«ri /)yt` <br /> Signature Registered Y/ Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature I Registered Y/N Fee Current Y/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 Fee Current Y/N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Current Y/N <br /> Address License# <br /> Directions <br /> Fill out application completely <br /> Owner 8 Contractor sign back of appiication,no;arized(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 />