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813-780-0020 Ciry of Zephyfiilis Fire Fax-813-780-0021 <br /> • Permit Application <br /> ate Received 1'2r 7� 'ZO�Z Phone Contact for Pertnit �( � � <br /> umer's Name v (ra..� �� Owners Phone Number `�� 88 y S� <br /> Vvner's Address -���a (�ea.« �(v c� �(� �+ 3'?yS'�r <br />�e Simple Titleholder Name Titleholder Phone Number � � �� <br />�e Simple Titleholder Address <br />�b Address �j� !/�/� Lot# �� <br />�b Division Parcel# <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 a Hood Installation <br /> � Emergency Generator<30 kw a LPlNaturai Gas-Installation <br /> � Emergency Generator>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL <br /> ❑�y emi �n er ❑ <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alartn � ❑ ❑ ❑ � � Spariclers <br /> Hood Cleaning � O ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � p ❑ � � � 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 /> Q Other: — <br />��hactor Company �/�� . . .� �` <br />�nature Registered Y/N Fee urrent Y/N <br /> Address .O. e ' / 6 License# <br />.ECTRICIAN Company <br />�nature I Registered Y/N Fee Current Y/N <br /> Address License# <br /> UMBER <br /> Company <br />�nature Registered Y/N Fee Cument Y/N <br /> Address License# <br />:CHANICA Company <br /> inature Registered Y/N Fee Cument Y/N <br /> Address License# �— � <br /> HER <br /> Company <br /> nature Registered Y/N Fee Current Y/N <br /> Address License# �� <br /> sctions: <br /> Fill out application completely <br /> Owner&Contractor sig�back of appiication,notarized(Or,copy of signed conVact with ovmer) <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 />