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s��3=780-0020 City of.Zephyrhilis Fire Fax-813780-0021 <br /> �Permit Application <br /> Date Received ��� v� � � �� Phone Contact for Permit JrT.�J -/3 <br /> +;a,"�.,�'a..�r,"riC���S�e6:. ... +»..n�.....M,.. , w»w ..,..o..-..a,»..w. .,�u.u..,...:.r,..,..,...........,..>. <br /> Owner's Name ���^G' � LQ � Ovmer's Phone Number ��3 �T� 93.5� <br /> Owner's Address • O� �0, 7�3� 7��tMP,�J r -�� 33 6'7� <br /> Fee Simple Titlehotder Name TiUeholder Phone Number � � .� <br /> Fee Simple Titleholder Address <br /> ��z�.. � <br /> Jab Address <br /> �fat F ;N o .o� i�T .�0 8 ����� .��v�. �ot# <br /> Sub Division Paroel# <br /> �� � Bio-Hazard Waste Storege-ANNUAL � Fumigation Tent <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility)ANNUAL <br /> � Controlled Bum � Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation <br /> � Emergency Generetor>30 kw � LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL a Places of Assembly-ANNUAL <br /> r y emi � er <br /> Sprinkler � ❑ L7 ❑ � Recreational Bum ��/��(` <br /> Fire Alarm ❑ ❑ ❑ � � Sparklers � I I <br /> Hood Cleaning � ❑ �d ❑ � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Toroh Roofing/Tar 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 /> ;�„ �°�. <br /> Contrector �� •� Company �i�s� <br /> Signature � Registered Y/N Fee Current Y/N <br /> Address License# <br /> ELECTRICIAN Company <br /> 5ignature I Registered Y/N Fee Current Y/N <br /> Address License# <br /> PLUMBER Company <br /> 5ignature 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 Current Y/N <br /> Address License# <br /> �-------- . .. .�. .... _ . ,, eh���va.a.�'..ke�.e�2�.,._._e,_...�..W=,. . . . , � .� . . ,. !vuxa���r��c . <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 woric over$500D) <br /> Supply two(2)sets of drewings with applicable documentation <br /> Allow�0-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:/lappreiser.pascogov.com) <br />