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s�s-�eo-oo2o City of Zephyrt�ills Fire Fax-813-780-002'I <br /> Permit Application <br /> 3te Received ` f�2�j'—/ Phone Contact for Pertnit $/ 99(, (�{ <br /> uvners Name �r�/da�N �or/'tC� Owner's Phone Number S� 7$� ��/�g <br />�nrner's Address �i$SS(r�s// B/ic� 1 �i I( 3 3 sy Z <br /> 3e Simple Titleholder Name Titleholder Phone Number � � � <br />�e Simple Titleholder Address <br />�b Address �/�"""�" Lot# � <br />�b Division Paroel# <br /> � Bio-Hazard Waste Storage-ANNUAL a Fumigation Tent <br /> a Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw a LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw a LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-ANNUAL �i �� � <br /> �y emi �n er '�'f (�.� <br /> (r <br /> Sprinkier � ❑ ❑ ❑ � Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � O ❑ ❑ � � Sprinkler System Installations <br /> i <br /> Hood Suppression � x ❑ � � Standpipes(SprinklerSys) wj� <br /> � Fire Alartn Installation � Torch RoofinglTar 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 /> mtractor Company �j�,G� �.y'�^� <br />�nature Registered Y/N Fee Current Y/N <br /> Address .D, g L,t,,,�+ p� 'fb 3 License# <br />.ECTRICIAN <br /> Company <br />�nature � Registered Y/N Fee Curtent Y/N <br /> Address License# <br />.UMBER <br /> Company <br /> 3nature Registered Y/N Fee Cument Y/N <br /> Address License# <br />=CHANICAL Company <br /> 3nature Registered Y/N Fee Current Y/N <br /> Address License# <br /> fHER <br /> Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address License# <br />�ections: <br /> Fill out appiication completely. <br /> Owner 8 Contractor sign back of application,notarized(Or,copy of signed contrect 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 t�-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />