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813-780-0020 City of Zephyrhilis Fire <br /> Fax-813-780-0021 <br /> Permit Application <br /> Date Received — S". ( r <br /> � � � °°�• .-. , Phone Contact for Permit <br /> - _ x�..._ « ,J.w.s l.. . 3sF.=E:<. ,. .... ,__� -rJ-��,`ws✓,3-Y...,Rir RP'>:K : } <br /> Owner's Name � ,n �--3�'�]� 9� , <br /> � C Owner's Phone Number �� � <br /> Owners Address S �'� � , � <br /> Fee Simple Titleholder Name � �� <br /> Titleholder Phone Number <br /> Fee Simple Titleholder Address <br /> , .,�r•a.w�:�.:�- _�.�°���:�,� �.:�r�c.���a ��=:�»�,�K:�- <br /> -�- .� _� »..�.,;-;��z.a�'x>_ . n�. <br /> Job Address �� <br /> Lot# <br /> Sub Division <br /> R �; - ��.,��..�.,>•.�-��-_,�. ..,.,_. <br /> Parcel# <br /> -�7-�f-�,�.-»,�,,�-. ; <br /> � . __" _ . ..,r.x._ ,';s;a_._s ...� :.�'tn-•-.,. ;g�.iS'ks�.'Md�'...e,.a� ��3."��- . i - , ,.,-,�..:,:yY`°,_ <br /> Bio-Hazard Waste Storage-ANNUAL a 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 � LP/Natural Gas-Installation <br /> � Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale <br /> � Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL <br /> ❑� emi � er ❑ <br /> Sprinkler ❑ ❑ ❑ Recreational Bum <br /> Fire Alarm � ❑ ❑ ❑ � � Sparklers <br /> Hood Cleaning � ❑ ❑ p � � Sprinkler System Installations <br /> Hood Suppression � ❑ ❑ ❑ �� � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch RoofinglTar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammable Application-ANNUAL <br /> � Valuation of Project <br /> Fuel Tanks <br /> Q Other: <br />, .����. m:..�:;.... ,,,,.:r ���, �-�s <br /> ��:��..i�..;.,� :��:� <br /> Contractor �� <br /> 5ignature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />=LECTRICIAN <br /> iignature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />'LUMBER <br />�ignature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> 1ECHANICAL <br /> ignature Company <br /> Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br /> THER <br /> ignature Company <br /> Registered Y/N Fee Current Y/IV <br /> Address <br /> rections: License# <br /> Fill out application completely <br /> Owner 8,Contractor sig�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 drewings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:l/appraiser.pascogov.com) <br />