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813-780-0020 City of Zephyrhilis Fire Fax-813-780-0021 <br /> . Permit Application <br /> te Received �'hone Gontact for Petmit tO <br /> �r:P.,�..�.: 'F.-m'M',�A]e�Mf1'Sid'i�� .Atl kNY&�7%Ab�.�.N3HF0.Pn4,41�Fi1�8bH�¢��•.D+A`Fh'1�I�tUM <br /> vner's Name Owner's Phone Number �� / c� cfc�'� <br /> {� � <br /> vner's Address C..- � "� r <br /> �e Simple Titleholder Name Titlehalder Phone IJurnber C� � � <br /> �e Simple Titleholder Address <br /> ��:,.N��� <br /> �bAddress (� LL- \,� Lot# � <br /> �b Division Parcel# <br /> rk� .. <br /> � Blo-Hazard Waste Starage-ANNUAL � Fumigation 7eM <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardeus Materfal(Tter II ar RQ Facility)�4iJNUAL <br /> � Contrnlled Bum Q Hood Instalfation <br /> � Emergency Generetor<30 kw � �°/Natura!Gas-Installation <br /> � Emergency Generator>30 kw � LP/NaYural Gas-kNNUlkL Sale / <br /> � Fire Protection Maintenartce-ANNUAL � Places of Assembly-ANh1UAL <br /> r y emi � er <br /> Sprinkler � 0 ❑ f� � Recreation8l Bum ��� <br /> Fire Alarm � ❑ � O � � Sparklers �/�/ ,� <br /> Hood Cleaning � � ❑ ❑ �� � Sprinkler System installations f � <br /> Hood Suppression � G ❑ ❑ C� � Standpipes(Sprihkler Sys) <br /> � Fire Alarm instailation � 7orch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> Fire Works <br /> � Flammable Application-ANNUAL Valuation of Project <br /> � Fuel7enks <br /> Q Other• <br /> k.;;��i,�5i�a. . _ . - . , <br /> Contractor �_�� --- _.____ Company l/ <br /> Signature Registered Y N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> Signature Registered Y/fv Fee Curcent Y/�I <br /> Address License# <br /> PLUMBER � Company <br /> Signatu�e Registered Y/N Fee Current Y/N <br /> Address License# <br /> MECHANICAL Company <br /> Signature Registered Y/N Fee Current Y!N <br /> Address License# <br /> OTHER Company <br /> Signature Registered Y/N Fee Curcent Y/N <br /> Address Ltcense# <br /> ,5pxu:�.:,.�;':� ., � ,,,vr .,.r,n.,, ...vi..r. . .Fe.n, n+a.. �.y �t�„ �H, r ,i;...,....i.s - �. ,�.,�:. �, .. . � ,. �.;y.,�s�.t..w;��8}�i� . . . s. . .. . xs;M'wf'�7��'AY",�..:d;�;W;�}:.'nf. <br /> Directions: <br /> Fifl out application compietely. <br /> Owner&Contractor sign back of application,notarized(Or,copy of signetl contract with owner) <br /> {f 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://eppraiser.pascogov.com) <br />