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a�s-�so-oozo City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> Date Received Phone Contact for Permit � � � <br /> • <br /> Owner's Name Owner's Phone Number � � <br /> Owner's Address �j . � — -J• , -?jZ2 <br /> Fee Simple Titleholder Name Titleholder Phone Number � � � <br /> Fee Simple Titleholder Address <br /> Job Address � 1 1 —� ✓�' � ���3 2 Lot# � <br /> -8nb'�'rvtSRSFS' S Parcel# <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen HoodlDuct a Hazardous Material(7ier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation � <br /> � Emergency Generator<30 kw � LPlNatural Gas-Installation � i ��� <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale ( „/fj <br /> � i- <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �j <br /> ry emi �n er S� <br /> Sprinkler � ❑ O ❑ B � Recreational Bum /�r�� <br /> / 1v <br /> Fire Alarm ❑ ❑ ❑ � � Sparklers J <br /> Hood Cleaning ❑ ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � 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 <br /> Signature c�.� Registered /N Fee Current Y!N <br /> Address License# <br /> ELECTRICIAN Company —1 <br /> Signature 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 Curtent 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&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 applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:!lappraiser.pascogov.com) <br />