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813-780-0020 City of Zephyrhilis Fire
<br /> FaX-a�saao-oo2�
<br /> Permit Application
<br /> phone Cantact for Permit
<br /> te Received . � �"'� '" � � �
<br /> ��,.,,�.;�»:���r,��
<br /> �
<br /> C ,� i Owner's Phone Number
<br /> vner's Name �
<br /> � � . 3"3� �
<br /> vner's Address � � �� �
<br /> Titlehalder Phone Number
<br /> �e Simpie Titleholder Name
<br /> �e Simple Titleholder Address �
<br /> ,4��: �,
<br /> `� ' 1 L� T3 L� a �ot#
<br /> Spy Address �
<br /> Parcei#
<br /> �b Division
<br /> �„iihF�V . �, - � �
<br /> � Fumigatio�7ent
<br /> 8in-Hazard Waste Storage-ANNUAL o
<br /> o Comm Exhaust Kitchen HoodlDuct Hazardous Materiat{Tier II or RQ Facility)ANNUAL
<br /> � Controlied Burn � Hood Instailation
<br /> � � LP/Natural Gas-Installation
<br /> Emergency Generator<30 kw �
<br /> � Emergency GenerBtor>30 kw LP/Natural Gas-/4NNUAL Sale
<br /> n F�re Protection Maintenance-ANNUAL
<br /> � Places of Assembly-ANNUAI
<br /> r y emi �n t er ❑
<br /> Sprinkler � C] Cl C] Recreational Bum
<br /> � Sparklers '� � � �
<br /> Fire Alarm � � � � � 2 �
<br /> j�J'� �, � � � � Sprinkler System instpllations 1� �J I '
<br /> ' Hood Cleaning X,]„J ❑ � / �
<br /> ❑ � � � C� Standpipes(5pnnk1�Cr Sys) �
<br /> Hood Suppression y,,,.
<br /> � Fire Alarrn�nstallation a Torch Roofing/Tar ttle _ --�°
<br /> � �-.-';�:.�=-
<br /> aW aste Tire Storage ANN
<br /> Fire Pumps
<br /> � Fire Works �'�"�""""
<br /> ❑ Valuation of Project
<br /> Flammable Application-ANNUAL
<br /> � R�7el7anks
<br /> � �her
<br /> :.m.�i�Y,k:�v;:E' . . _
<br /> 1 Company
<br /> Contractor c— _ Registered /f�f Fee Current Y/N
<br /> 5ignature �
<br /> License# ���—
<br /> Address
<br /> Company
<br /> ELEC7RICIAN Registered Y!N Fee Current Y/nl
<br /> Signature �
<br /> License#
<br /> Address
<br /> Company
<br /> PLUMBER
<br /> Registered Y I N Fee Current Y
<br /> Signature
<br /> License#
<br /> Address
<br /> MECHANICAL Company
<br /> Registered Y/N Fee Curcent Y/N
<br /> Signature
<br /> License#
<br /> Address
<br /> OTHER Company
<br /> Registered Y/N Fee Current Y/N
<br /> Signature �
<br /> �icense# � y�,,,,,R. .. ,,, ,
<br /> Address , �,,:.,;.,;.,...:,.,�y,;:,,, �,- ,��:�;,��a�t���°,.� . .
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<br /> Directions:
<br /> Fili out application comp{etely
<br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contracc with owner)
<br /> If over$2500,a Notice of Commencement is required(Mechanica!work over$5000)
<br /> Supply two(2)sets of drawings with applicable documentation raiser. ascogov.com
<br /> Allow 10-14 days for review after submittal date Parcel#-obta+ned from Property Tax Notice(http://app P )
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