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Fax-813-780-0021 <br /> ai aaao-oo2o City of Zephyrhilis�Fir.e• <br /> Permit Application l' <br /> TU �2 � � /3 - Phone Contact for Pertnit �-3 � -ST, ��_K��_„�� <br /> 7` �*��_ �,:�,«z..-,... <br /> Date Received .,,,_, ,„�;��:� � ._ �J 3 SL�� G7 3 s� <br /> .��.;�.,., ..�-;��:a��:.:..._ .,.,,:,_._....�..� �� �, r <br /> `u �" G�S Z �� '���V�T� Owner's Phone Number <br /> Owner's Name �L 3 3�� <br /> Owner's Address <br /> r 0. �OX �7�:�� ��fl/���1 C� C� � <br /> Titleholder Phone Number <br /> Fee Simple 7itleholder Name <br /> Fee Simple 7itleholder Address _ � ��"�` � <br />;-��..� .c� • Gf►��, l3C1/D. �ot� �� <br /> Job Address <br /> C�`l�'7?��bOX Cft�� � <br /> Parcel# _ <br /> Sub Division <br /> .. � � Fumigation Tent <br /> Bio-Hazard Waste Storage-ANNUAL � <br /> Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> aComm Exhaust FGtchen HoodlDuct � <br /> � Hood Installation <br /> Controlled Bum � <br /> � LP/Natural Gas-Installation <br /> Emergency Generator<30 kw a LP/Natural Gas-ANNUAL 5ale <br /> � Emergency Generator>30 kw � places of Assembly-ANNUAL <br /> � Fire Protection Maintenance-ANNUAL <br /> ❑ (Lr y emi �n er <br /> � � � � Recreational Bum ��� <br /> 5prinkler � � �/ � <br /> ❑ ❑ ❑ ❑ Sparklers / , <br /> Fire Alarm � � � [ ` <br /> � � � Sprinkler System Instaltations <br /> Hood Cleaning ,..�_^ � <br /> I I Standpipes(Sprinkler Sys) <br /> Hood Suppression � � � � L.J � <br /> � Torch RoofinglTar Kettle <br /> Fire Alartn Installation � <br /> aWaste Tire Storage ANNUAL <br /> Fire Pumps <br /> � Fire Works Valuation of Project <br /> � Flammable Application-ANNUAL <br /> � Fuel Tanks <br /> � Other: <br /> / Company ' !Vl!/ '� S��✓/G F <br /> Contractor /7 />„ �i �__--• Registered Y/N Fee Current Y/N <br /> Signature �� Zy���� � <br /> License# �_ <br /> Address <br /> Company <br /> ELECTRICIAN Registerad Y/N Fee Curtent Y/N <br /> Signature � �� <br /> License# <br /> Address <br /> Company <br /> PLUMBER Registered Y/N Fee Gurtent Y/N <br /> Signature � <br /> License# <br /> Address <br /> Company <br /> MECHANICAL Registered Y/N Fee Current Y/N <br /> Signature � <br /> License# <br /> Address <br /> OTHER Company <br /> Registered Y/N Fee Current Y/N <br /> Signature <br /> License# <br /> Address ' �""°"' <br /> Directions: <br /> FiII out application completely <br /> Owner&Contraetor sig�back of appiication,notarized(�r,copy of signed contract with owner) <br /> tf over$2500,a Notice ofi 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:/lappra�ser.pascogov.com) <br />