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813-780-OD20 <br /> City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Appli�ation <br /> Whonb Ctsrtta�tar'P�t+n'fit S�3� �6 <br /> �:e Recelved �;x�,��aAV,�n��+ • <br /> �ri�m��u.�� �� <br /> �l,,,l L J �,(� �f Owner's Phone Numtrer � � � <br /> vner's Name �Z c�/ <br /> vner's Address V � Y Z ���" r��� ' ��`� 2 f�(llS r C l 3 5 -` l <br /> �e Simpie Titl�holder hlama TfUeholder Phone Nutnber ,�� �, ,� <br /> �. __�l <br /> :e Simple Titlehalder Address <br /> �. � 2 G�acc l3 Gut� �C=PId 2/�C�f r �"� 33.5 K ( �dt� <br /> .,,.� �" �..t <br /> )4b Address <br /> Parcel# <br /> j�b Division <br /> sa�a�+�m:s�;WA9M� � . , � <br /> � 810-Hazard Wa5te Stor2ge-ANMUAL � Fumig�tion 7ettt <br /> � Comm Exhaust Kitchen Hood/Duci � Hazardous Nla't�Yl�l{?iet II ar RC�Facflity)�1W�IU�4L <br /> � Controlied Burn � Hood Instaifation <br /> � Emergenoy Generator<30 kw � LP/Natural f3as-lnstaliatian <br /> � �mergency Gener�tor�30 kw � LP/Natural Gas-kNWW/�L Sele <br /> � Fire ProYeCtion Maintenance-IkNNUAL � Places of,�ssetritily-/l'wWUAt <br /> ❑ ;tSiTy �m �]Tn t er � ��1�I <br /> Sprinkler C5 f� Gl RecreStirnsl8um � ( <br /> Fire Alarm � �' � n � � Spgrkl�rs <br /> Hood Cleaning �D � � �1 � ❑ Sprinkler System Installatians <br /> hloc�dSuppression � ❑ ❑ n �� � Standpfpgs'(Spri�rl�f�r9ys) <br /> � Fire Alarm instailation � 7or�h F�oofing/7'ar K+ettl� <br /> � Fire Pumps � Waste�'ire 5toiage AtRIWUAt <br /> Fire Works <br /> Flammable Application-ANNUAL �-� Waluation.of Project <br /> 1� Fuei Tanks <br /> Q Other• <br /> ���� . � <br /> Contractor Comparly � /� ��� r���� <br /> _ __ _.f��_..___._. Registered N Fee Current Y� <br /> Signature <br /> Address . O ,� � C-��S�.G G E� f=-C T5 License# <br /> ELECTRICIAN Comp�ny <br /> Signature Registered Y!I�I Fee Current `P'/N <br /> Address License# <br /> PLUMBER � �ompeny <br /> Signature Registered �'.7.(�J Pee Current Y/fd : <br /> Address License# <br /> MECHANICAL Compeny <br /> Signature Registered Y/1'±) Fee Curcent Y/N <br /> Address �— License# <br /> OTHER Company <br /> Signature Reglstered Y/N Fee Current Y/N <br /> Address Lfcense# � o ����, ,���� <br /> wr,i i r��.n�:c � ..�a+.: i�.t,�i ��.;.r.� o�.•w+...e,ncn-.,�.w•,,-rr��.��.,�a�a,��w, ...a�� . . . .. �Sa�Lr7i�k'r5fi2�+i�`dR ��i , <br /> 7. .V. <br /> IJ'���q3��,'�G"iLLtP,'fia6fyt. 4aRpusls;s ., .mynq. .. : � <br /> Directions. <br /> Fitl out appiication comp'etelY <br /> Owner�Contr2Ctor Sign'�aCk of application notarized(Or,copy of stgneo con;ract wtth owner) <br /> If over$2500,a Notice of Commencement is required(Meohanfcal woric over$5000} <br /> Supply twc(2)sets of drawings with applicable documentation <br /> Allow�0-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http:/lsppraiser.pascogov.com) <br />