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,_—_� <br /> 813-780-0020 City of Zephyrhilis Fire <br /> Fax-613-780-0021 <br /> Permit Application <br /> Date Received � <br /> Phone Contact for Permit 9 L�� 9j��, Gj�?,c <br /> owner's Name (�(�1r �(� (�„�y� ��3 �(y� 22�OZ <br /> Owner's Phone Number <br /> Owner's Address �Q �� �'��"'�'Z� � � � �1 �12,�C,,L <br /> V JJ D <br /> Fee Simple Titieholder Name � �� �� <br /> Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> JobAddress 5�35 L�c�il ��v�.,., Ze h�rh,i,��5 , �� 335yz � <br /> Lot# <br /> Sub Division <br /> Parcel# 10-2�v-2�'p���pQ f,�I�-C)O�JC� <br /> � Bio-Hazard Waste Storage-ANNUAL � <br /> � Fumigation Tent <br /> Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Burn � Hood Installation <br /> � Emergency Generator<30 kw � <br /> � LP/Natural Gas-Installation <br /> Emergency Generator>30 kw � LP/Naturel Gas-ANNUAL Sale � <br /> � � <br /> Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL � <br /> � r y emi � er ❑ � <br /> Sprinkler ❑ ❑ ❑ Recreational Burn <br /> Fire Alarm � ❑ ❑ y�, � ❑ <br /> �v Sparklers <br /> Hood Cleaning ❑ ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ Standpipes(Sprinkler Sys) <br /> � Fire Alarm Instailation � Torch RoofinglTar Kettle <br /> � Fire Pumps a Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Aoplicztion-aNNL!et <br /> � Fuel Tanks I 'vaivation of Project <br /> Q Other <br /> Contractor <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> ELECTRICIAN <br /> Signature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# � <br /> PLUMBER <br /> Signature Company <br /> Registered � T%IV � Fee Current Y/N <br /> Address <br /> License# <br /> MECHANICAL <br /> Signature Company <br /> Registered Y/N Fee Curcent Y/N <br /> Address �, � <br /> License# <br /> OTHER <br /> Signature ��—.�� _ � I ���� Company �m - � �� Q� <br /> Registered N Fee Current N <br /> Address �'j' �S �,� �p�.�� L 342 <br /> License# r ����� <br /> Directions. <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract 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 /> Ailow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice htt //a <br /> ( p: ppraiser.pascogov.com) <br />