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817-780.0020
<br /> City of Zephyrhiils Fire � I ����� Fax-813780-0021
<br /> Pertnit Application
<br /> �ete Recelved Phone Contact for Pertnit � � 3 �2 O (02 Z'7
<br /> iwners Name ����N'� � � q Ownafs Phone Number � C� �
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<br /> �wners Address �o�o�� �T A'U�. 6 LV h �/►�'��1�1 �'�. 33 S�I 2�
<br /> ee Simple TiHeholder Name Titleholder Phane Number � � ��
<br /> ee Simple Titteholder Address , ,
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<br /> ob Address
<br /> : SArrv�4. � � Arti3 o J 4. ^�at# �
<br /> ub Division Per�el#
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<br /> � BiaHazard Waste Storage-ANNUAL � Fumigation Tent
<br /> � Comm Exhaust Kitchen Nood/Duct � Hazarcfous Material(Tier 11 or RQ Facility)ANNUAL
<br /> � Controlled Bum � Nood InstallaUon
<br /> � Emargency Generator<30 kw � LPfNatural Gas-InstallaUon
<br /> � Emergencyr Generalor>30 kw a LP1Natural Gas-ANNUAL Sale
<br /> a Fire ProtecUon Maintenance-ANNUAL � Places of Assembly-ANNUAL ��l7� S����
<br /> � 8� � � ���1..
<br /> 5prinkler � ❑ ❑ O � Recreational Bum
<br /> Fire Alarm � ❑ ❑ ❑ � � Sparkiers � � �S /'2� �3
<br /> Fbod CleaNng � ❑ E� 0 � � Sprinkler System InstaNations
<br /> Fiood Suppression � ❑ Q ❑ � � SWndpipes(5prinkler Sys)
<br /> � Fire Alartn InstallaUon � Toroh Rooflng/Tar Ketlie
<br /> Fire Pumps � Wasle Tre Storage ANNUAL
<br /> Fire Works
<br /> Flammable Application-ANNUAL Valuation of Project
<br /> � Fuel7enks
<br /> Q Other.
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<br /> :ontrador �---� � Comparry 'TNDi "Tt-Ard�. G1 .
<br /> dgnature Registered N Fee Current N
<br /> Address t�"j'7'Z."2— ►'V 6pD S�-�r4,h l�: n�P4 'Gli License#
<br /> 1ECTRICIAN '�j3 io�- Comparry
<br /> dgnature � Registered Y/N Fce Curront T Y/N
<br /> Address Licensa# �
<br /> �.UMBER Company —�
<br /> �ignature Registered Y/N Fee Current Y/N
<br /> Address Ltcense#
<br /> 1ECHANICAL. Company
<br /> ignaiure r'teglstered Y/N Fee Curtent �l/1�
<br /> Address Ltcense#
<br /> �THER Company
<br /> .ignature Registered Y/N Fee Current Y 1 N
<br /> Addreas Ucense!�
<br /> N►ections . . ` . . . . �. �
<br /> Ffll out applicaUon completely.
<br /> Owner�CoMradw sfgn back of applicaUon,notarized(Or,copy ot signed conVact with owner)
<br /> If ovar 52500.a Notice of Commencement Is required(Mechenical woric over 35000)
<br /> Supply Mro(2)sets of drawings with applicable dowmentaUon
<br /> Allow 10.14 days for review after submittal date. Pan�el#-obtained from Property Tax Notice(httpJlapprofser.pascogov.com)
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